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saqarTvelos eqimis qcevis wesebi Tbilisi, 2010 weli
proeqti farTo sazogadoebrivi ganxilvisTvis
Sinaarsi
Sesavali................................................................................................................................................................. 4 1. zogadi nawili:..................................................................................................................................... 7
1.1. `saqarTvelos eqimis qcevis wesebis~ mizani..........................................................................................7 1.2. visTvis aris gamiznuli `saqarTvelos eqimis qcevis wesebi~ ....................................7 1.3. `saqarTvelos eqimis qcevis wesebis~ safuZvlebi ......................................................................7 1.4. eqimis profesiuli saqmianobis zogadi principebi ...............................................................9
1.4.1 samedicino eTikis fuZemdebeli principebi......................................................................................9 1.4.2 eqimis profesiuli saqmianobis mizani...................................................................................................9 1.4.3 profesiuli damoukidebloba..........................................................................................................................9 1.4.4 profesiuli kompetencia.....................................................................................................................................10 1.4.5 kanonmdeblobis codnis da dacvis aucilebloba ..................................................................10 1.4.6 profesiis prestiJi...................................................................................................................................................10
2. kerZo nawili.........................................................................................................................................11 2.1. eqimis damokidebuleba pacientTan profesiuli movaleobis aRsrulebisas........................................................................................................................................................................................... 11
2.1.1 pacientis avtonomiis pativiscema ............................................................................................................. 11 2.1.2 Tanabari da samarTliani damokidebuleba ..................................................................................... 11 2.1.3 informaciis miwodeba ............................................................................................................................................12
2.1.3.1 informaciis miwodeba pacientisaTvis ............................................................................................................ 12 2.1.3.2 informaciis miwodeba pacientis axloblisTvis an kanonieri warmomadgenlisTvis ............................................................................................................................................................................. 14
2.1.4 informirebuli Tanxmoba, pacientis gadawyvetilebis pativiscema ......................14 2.1.4.1 pacientis uari samedicino momsaxurebis gawevaze............................................................................. 16 2.1.4.2 pacientis winaswar gacxadebuli neba............................................................................................................. 16
2.1.5 informaciis konfidencialuroba .............................................................................................................17 2.1.6 pirad cxovrebaSi Caurevloba......................................................................................................................18 2.1.7 pacientis monawileoba studentebis, rezidentebis, eqimebis swavlebasa da mzadebaSi................................................................................................................................................................................................18 2.1.8 holistikuri midgoma: pacientTan urTierTobis biofsiqosocialuri modeli......................................................................................................................................................................................................19 2.1.9 eqimi – komunikaciis eqsperti ...................................................................................................................... 20 2.1.10 eqimi rogorc pacientis maswavlebeli ...............................................................................................21 2.1.11 eqimi da rTuli pacienti .................................................................................................................................. 22 2.1.12 momsaxurebis uwyvetoba, momsaxurebaSi sxva personalis CarTva ..........................23 2.1.13 eqimis uari samedicino momsaxurebis gawevaze, samedicino momsaxurebis Sewyveta................................................................................................................................................................................................... 25
2.1.13.1 eqimis profesiul kompetenciasTan da resursebis ukmarisobasTan dakavSirebuli uari..............................................................................................................................................................................26 2.1.13.2 samedicino da eTikur kriteriumebTan an akrZalvasTan dakavSirebuli uari.26 2.1.13.3 eqimis usafrTxoebasTan dakavSirebuli uari ..................................................................................26 2.1.13.4 eqimis moralur SexedulebebTan dakavSirebuli uari ...........................................................27 2.1.13.5 samedicino momsaxurebis Sewyveta da pacientTan profesiuli urTierTobis dasruleba pacientis qcevis gamo...........................................................................................................................................27
2.2. eqimi da sazogadoebis daucveli, mowyvladi nawili...................................................... 28 2.2.1 arasrulwlovnebi...................................................................................................................................................... 28
2
2.2.2 braldebulebi da msjavrdebulebi.........................................................................................................30 2.2.2.1 moSimSile braldebuli da msjavrdebuli................................................................................................30
2.2.3 orsuli, mSobiare da meZuZuri deda..................................................................................................... 31 2.2.4 eqimi da fsiqikuri daavadebis mqone pacientebi, romlebsac SezRuduli aqvT gadawyvetilebis miRebis unari ........................................................................................................................32 2.2.5 pacienti ganukurnebeli daavadebis terminalur stadiaze, paliatiuri mzrunveloba, tkivilis marTva.......................................................................................................................................32 2.2.6 evTanazia, eqimis daxmarebiT suicidi ..................................................................................................34
2.3. gadaudebeli samedicino momsaxureba....................................................................................................34 2.4. adamianis organoebisa da qsovilebis gadanergva..................................................................35 2.5. tvinis sikvdili...............................................................................................................................................................35 2.6. eqimis moqmedeba resursebis ukmarisobisas....................................................................................36 2.7. eqimi da pacientis axloblebi, ojaxis wevrebi.......................................................................36
2.7.1 pacientis ojaxis wevrebi samedicino dawesebulebaSi......................................................37 2.7.2 urTierToba ojaxis wevrebTan pacientis sikvdilis SemTxvevaSi.........................38
2.8. eqimi da kolegebi .........................................................................................................................................................39 2.8.1 kolegis pacienti........................................................................................................................................................39 2.8.2 konsiliumi........................................................................................................................................................................ 40 2.8.3 kolegis mowveva ...........................................................................................................................................................41 2.8.4 kolegis saqmianobis Sefaseba.......................................................................................................................41 2.8.5 zrunva kolegis profesiul kompetenciaze .................................................................................. 42 2.8.6 kolegis janmrTelobaze zrunva .............................................................................................................. 42
2.9. eqimi da sazogadoeba............................................................................................................................................... 42 2.9.1 mosaxleobaSi cxovrebis jansaRi wesis damkvidrebisaTvis xelSewyoba ...... 42 2.9.2 momsaxurebis xelmisawvdomobisaTvis zrunva............................................................................. 42 2.9.3 eqimis profesiisadmi ndobis damkvidreba .......................................................................................43
2.10. eqimi da masobrivi informaciis saSualebebi ............................................................................43 2.11. eqimi da TviTmkurnaloba, eqimis mier sakuTari ojaxis wevrebis mkurnaloba .............................................................................................................................................................................................. 44 2.12. eqimi da industria...................................................................................................................................................... 44 2.13. eqimi da dazRvevis sistema ............................................................................................................................... 46 2.14. saCuqari eqims .................................................................................................................................................................... 46 2.15. eqimis saqmianobis TviTreklama ................................................................................................................ 47 2.16. eqimis urTierToba damqiravebelTan, SromiTi xelSekruleba............................ 47 2.17. samedicino momsaxurebis xarisxi da pacientis usafrTxoeba................................ 48
2.17.1 samedicino momsaxurebis xarisxisa da pacientTa usafrTxoebis uzrunvelyofaSi monawileoba........................................................................................................................................ 48 2.17.2 samuSao garemo............................................................................................................................................................. 49
2.18. samedicino dokumentaciis warmoeba..................................................................................................... 50 2.19. eqimis moqmedeba, roca samedicino momsaxureba warumatebeli aRmoCndeba .................................................................................................................................................................................................51 2.20. eqimis moqmedeba saeqimo Secdomis daSvebisas ......................................................................... 52 2.21. momCivani pacienti.......................................................................................................................................................53 2.22. eqimi da samarTaldamcavi organoebi, sxva saxelmwifo dawesebulebebi..53 2.23. sakuTar profesiul kompetenciaze zrunva, uwyveti profesiuli ganviTareba.............................................................................................................................................................................................. 54 2.24. eqimi da axali teqnologiebi ...................................................................................................................... 54 2.25. eqimi da telemedicina.............................................................................................................................................55 2.26. eqimi mkvlevari ................................................................................................................................................................55 2.27. eqimi maswavlebeli......................................................................................................................................................58
3. saqarTvelos eqimis qcevis wesebis danergva.....................................................59 3.1. `saqarTvelos eqimis qcevis wesebis” aRiareba dargobrivi asociaciebis mier 59
3
`rac unda mdidari qveyana unda iyos bunebiT, Tu iq Cemi
da Seni, ese igi kacTa ufleba da movaleoba, Znelad
gasarCevia da ar aris sayovelTaod gansazRvruli cxadad
da ucilod, iq xalxis warmateba da keTildReoba, Tu
yoveldRe ukan ar iwevs, Seferxebuli xom aris da aris.~
ilia WavWavaZe
`cxovreba da kanoni~, gazeTi `iveria~ 1877 w.
4
Sesavali
samoqalaqo sazogadoebis Camoyalibebis, progresisa da
keTildReobis winapirobaa yvela sferoSi, maT Soris, jandacvis
sistemaSi, kanonis uzenaesoba, adamianis uflebebis pativiscema,
adamianebs Soris urTierTobis eTikuri normebisa da qcevis wesebis
dacva.
saeqimo saqmianobis warmatebulad da Rirseulad warmarTvis,
samedicino momsaxurebis adekvaturi xarisxis uzrunvelyofis
safuZveli, garda samedicino codnisa da unar-Cvvebisa, aris
kanonmdeblobaSi asaxuli normebis, sayovelTaod aRiarebuli
eTikuri principebis da qcevis wesebis codna da gamoyeneba. amisaTvis
ki aucilebelia saxelmZRvanelo, romelSic pacientTan, mis ojaxis
wevrebTan da axloblebTan, kolegebTan, studentebTan,
rezidentebTan, agreTve, masobrivi informaciis saSualebebis,
samarTaldamcavi organoebis, industriis warmomadgenlebTan da a.S.
urTierTobis principebi, wesebi iqneba asaxuli.
swored zemoxsenebuliT ganisazRvreba winamdebare `saqarTvelos
eqimis qcevis wesebis” saWiroeba; saxeldobr, man xeli unda Seuwyos:
§ pacientis interesebis uzenaesobis dacvas eqimis profesiuli
saqmianobisas;
§ komunikaciis unar-Cvevebis optimalur doneze standartizacias
eqimebs Soris;
§ swori gadawyvetilebis miRebas im SemTxvevebSi, rodesac eqimi
samarTlebrivi da eTikuri dilemis winaSe aRmoCndeba xolme –
pacientisaTvis e.w. `cudi ambebis~ (mag., fataluri daavadebis
diagnozi) Setyobineba, patimrebTan urTierToba, sicocxlis
SemanarCunebeli mkurnalobis Sewyveta, tvinis sikvdilis
konstataciis Semdeg samoqmedo strategiis gansazRvra da
realizacia, adamianis organoebis aReba da gadanergva da
mravali sxva.
5
`saqarTvelos eqimis qcevis wesebi” efuZneba saqarTvelos
jandacvis sferos kanonmdeblobiT gaTvaliswinebul normebs,
`saqarTvelos eqimis eTikis kodeqsSi~ asaxul principebs,
saerTaSoriso organizaciebis mier mowodebul rekomendaciebs
pacientis da eqimis ufleba-movaleobebis Sesaxeb.
`saqarTvelos eqimis qcevis wesebSi” asaxuli rekomendaciebi,
romlebic saqarTvelos kanonmdeblobiT dadgenil moTxovnebs
emyareba, Sesasruleblad savaldebuloa.
saxelmwifom, SesaZleblobebis farglebSi, xeli unda Seuwyos
`saqarTvelos eqimis qcevis wesebSi~ asaxuli rekomendaciebis
danergvas samedicino dawesebulebebSi saTanado garemos SeqmniT,
eqimebisaTvis motivaciis CamoyalibebiT.
ZiriTadi roli rekomendaciebis danergvaSi eqimTa sazogadoebas,
profesiul asociaciebs ekisreba. am ukanasknelTa wevrebis mier
rekomendaciebis aRiareba da ganxorcieleba profesiuli
asociaciebis wevrobis erT-erT kriteriumad SeiZleba iqnes miCneuli.
* * *
gasuli saukunis 90-iani wlebis Suagulidan moyolebuli
damoukidebel saqarTveloSi Camoyalibda janmrTelobis dacvis
sferos kanonmdebloba, romelic aregulirebs eqimis profesiul
saqmianobas, pacientis uflebebs da esadageba saerTaSoriso
sazogadoebriobis mier aRiarebul sakanonmdeblo Tu eTikur normebs.
1999 wlidan imJamindeli jandacvis marTvis nacionaluri centris
jandacvis kanonmdeblobisa da bioeTikis ganyofilebis
TanamSromlebi da saqarTvelos bioeTikisa da janmrTelobis dacvis
samarTlebrivi sakiTxebis Semswavleli sazogadoebis wevrebi
muSaobdnen saqarTvelos eqimis eTikis kodeqsis proeqtze. 2003 wlis
6 maiss saqarTvelos eqimTa pirvelma kongresma miiRo saqarTvelos
eqimis eTikis kodeqsi.
`saqarTvelos eqimis qcevis wesebis” momzadebis iniciatoria
amerikis saerTaSoriso ganviTarebis saagentos (USAID) jandacvis
sistemis ganmtkicebis (USAID - HSSP) programa. 2010 wlis 5 ivliss
6
`saqarTvelos eqimis qcevis wesebis” momzadebis Sesaxeb gaformda
memorandumi moxseniebul programasa da Semdeg arasamTavrobo
organizaciebs Soris: `saqarTvelos bioeTikisa da jandacvis sferos
samarTlebrivi sakiTxebis Semswavleli sazogadoeba~, `saqarTvelos
ojaxis eqimTa asociacia~, `saqarTvelos saojaxo medicinis
profesionalTa kavSiri~ da `saqarTvelos eqimTa asociacia~.
CamoTvlili organizaciebis warmomadgenelTagan Seiqmna samuSao
jgufi Semdegi SemadgenlobiT: givi javaSvili (jgufis xelmZRvaneli;
saqarTvelos bioeTikis da janmrTelobis dacvis samarTlebrivi
sakiTxebis Semswavleli sazogadoeba), guram kiknaZe (saqarTvelos
ojaxis eqimTa asociacia), irina qarosaniZe da Tamar gabunia
(saqarTvelos saojaxo medicinis profesionalTa kavSiri), revaz
TaTaraZe da giorgi wilosani (saqarTvelos eqimTa asociacia).
`saqarTvelos eqimis qcevis wesebze” muSaoba dasrulda 2010 wlis
dekemberSi. 2011 wlis ianvridan daiwyo `saqarTvelos eqimis qcevis
wesebis~ farTo sazogadoebrivi ganxilva.
`saqarTvelos eqimis qcevis wesebi” momzadda zemoT CamoTvlili
organizaciebis warmomadgenlebis keTili nebis safuZvelze, raime
anazRaurebis gareSe.
* * *
7
1. zogadi nawili:
1.1. `saqarTvelos eqimis qcevis wesebis~ mizani
`saqarTvelos eqimis qcevis wesebis~ mizania xeli Seuwyos
saqarTveloSi eqimis profesiuli saqmianobis Sesabamisobas
sayovelTaod aRiarebul profesiul, eTikur da samarTlebriv
normebTan, rac uzrunvelyofs:
§ samedicino momsaxurebis xarisxis amaRlebas;
§ pacientebis usafrTxoebas;
§ eqimsa da pacients Soris urTierTndobisa da
TanamSromlobisaTvis keTilganwyobili garemos damkvidrebas;
§ eqimis avtoritetis zrdas.
1.2. visTvis aris gamiznuli `saqarTvelos eqimis qcevis wesebi~
`saqarTvelos eqimis qcevis wesebi” gamiznulia saqarTveloSi
momuSave eqimebisa da yvela pirisaTvis, romlebic eqimis funqcias
asruleben – rezidentebi, doqtorantebi, studentebi.
amasTan, sasurvelia, rom `saqarTvelos eqimis qcevis wesebiT”
ixelmZRvanelon jandacvis sxva profesionalebmac (mag., eqTnebi);
Tumca, am ukanasknelTa profesiul saqmianobas, SesaZloa,
awesrigebdes maTi specialobisTvis SemuSavebuli qcevis normebi.
`saqarTvelos eqimis qcevis wesebi” gankuTvnilia farTo
sazogadoebisTvisac, romelmac, sasurvelia, kargad icodes, ras
unda moelodes eqimisagan.
1.3. `saqarTvelos eqimis qcevis wesebis~ safuZvlebi
`saqarTvelos eqimis qcevis wesebi” efuZneba saerTaSorisod
aRiarebul da qveyanaSi damkvidrebul faseulobebs da
Sexedulebebs pacientTan damokidebulebis, janmrTelobis dacvis,
adamianis uflebebisa da eqimis profesiuli saqmianobis
sferoebSi. imavdroulad, is gamomdinareobs `saqarTvelos eqimis
eTikis kodeqsidan~, romelic gansazRvravs saqarTveloSi eqimis
profesiuli saqmianobis fundamentur eTikur principebs.
8
`saqarTvelos eqimis qcevis wesebSi” asaxulia qvemoT
CamoTvlil erovnul da saerTaSoriso, savaldebulo Tu
deklaraciuli bunebis dokumentebSi mocemuli debulebebi,
romelic eqimis profesiuli saqmianobis samarTlebriv da eTikur
regulacias isaxavs miznad:
a) saqarTvelos kanonebi `saeqimo saqmianobis Sesaxeb~ (2001 w.),
`pacientis uflebebis Sesaxeb~ (2000 w.) da `janmrTelobis dacvis
Sesaxeb~ (1997 w.), agreTve, kanonebi, romlebic jandacvis
specifikur dargebs awesrigebs, mag.: kanonebi `sazogadoebrivi
janmrTelobis Sesaxeb~ (2007 w.), `aiv infeqcia/Sidsis Sesaxeb~
(2009 w.), `fsiqiatriuli daxmarebis Sesaxeb~ (2006 w.) `adamianis
organoebis gadanergvis Sesaxeb” (200 w.) da sxv.
b) evropis sabWos samarTlebrivi instrumentebi
janmrTelobis dacvis, biomedicinisa da adamianis uflebebis
sferoSi, maT Soris konvencia `adamianis uflebebisa da
biomedicinis Sesaxeb~ (1997 w.) da misi damatebiTi oqmebi;
g) jandacvis msoflio organizaciis deklaracia `evropaSi
pacientTa uflebebisaTvis xelSewyobis Sesaxeb~ (1994 w.);
d) gaerTianebuli erebis saganmanaTleblo, samecniero da
kulturis organizaciis (`iuneskos”) `sayovelTao deklaracia
bioeTikisa da adamianis uflebebis Sesaxeb~ (2005 w.),
gaerTianebuli erebis organizaciis `samedicino eTikis
principebi~ (1982 w.);
e) msoflio samedicino asociaciis `samedicino eTikis
saerTaSoriso kodeqsi~ (1949 w.) da deklaraciebi, maT Soris,
Jenevis, lisabonis, helsinikis, tokios, hamburgis da sxva.
9
1.4. eqimis profesiuli saqmianobis zogadi principebi
1.4.1 samedicino eTikis fuZemdebeli principebi
pacientisaTvis samedicino daxmarebis gawevisas eqimis
saqmianoba da gadawyvetilebebi unda efuZnebodes samedicino
eTikis oTx fuZemdebel princips:
a) pacientis avtonomiis pativiscema – pacientis
Sexedulebebis da misi gadawyvetilebis pativiscema,
pacientisaTvis mxardaWera gacnobierebuli da Tavisufali
gadawyvetilebis miRebaSi;
b) sargeblianoba (`sikeTis qmna~) – pacientis sicocxlisa da
janmrTelobisaTvis maqsimalurad sasargeblo gadawyvetilebis
miReba;
g) zianis armiyeneba (`ar avno~) – zianis Tavidan acileba;
TiTqmis yvela samedicino Carevas axlavs garkveuli ziani, magram
mosalodneli sargebloba yovelTvis unda aRematebodes
savaraudo zians; amasTan, eqimi unda ecados zianis minimumamde
Semcirebas;
d) samarTlianoba – sargeblobis, riskis, agreTve, xarjebis
Tanabari ganawileba; erTi mxriv, Tanabar mdgomareobaSi myofi
pacientebisadmi Tanabari damokidebuleba, xolo, meore mxriv,
arasakmarisi resursebis ganawilebisas pacientis janmrTelobis
saWiroebebis gaTvaliswineba.
1.4.2 eqimis profesiuli saqmianobis mizani
eqimis saqmianobis mizania individis, ojaxis, mTlianad
sazogadoebis janmrTelobaze zrunva – janmrTelobis
SenarCuneba da aRdgena, adamianisaTvis tanjvis Semsubuqeba.
1.4.3 profesiuli damoukidebloba
profesiuli gadawyvetilebis miRebisas eqimi Tavisufali da
damoukidebelia. is xelmZRvanelobs mxolod profesiuli
standartebiT da sayovelTaod aRiarebuli eTikuri normebiT.
10
eqimi yovel Rones xmarobs, rom win aRudges winamdebare
`saqarTvelos eqimis qcevis wesebSi” asaxuli principebisa da
eTikuri normebis sawinaaRmdego moqmedebisaken mowodebas.
1.4.4 profesiuli kompetencia
eqimi yovel Rones xmarobs mocemuli specialobisTvis
qveynaSi aRiarebuli profesiuli kompetenciis (codna, unar-
Cvevebi da damokidebuleba) mopovebisa da SenarCunebisaTvis,
eqimi Tavis saqmianobas warmarTavs aRniSnuli kompetenciis
farglebSi.
amasTan, eqimi cdilobs uari Tqvas iseT samedicino
momsaxurebaze, romelic, misi azriT, mocemul momentSi ar
esadageba mis codnas da unar-Cvevebs, miuxedavad imisa, rom
momsaxurebis es saxe Seesabameba mis specialobas.
1.4.5 kanonmdeblobis codnis da dacvis aucilebloba
eqimi kargad icnobs da icavs qveyanaSi arsebul
kanonmdeblobas, romelic mis profesiul saqmianobas
aregulirebs. amasTan, eqimi cdilobs xeli Seuwyos
kanonmdeblobaSi asaxuli im normebis Secvlas da daxvewas,
romelic, eqimis azriT, ewinaaRmdegeba pacientisa da
sazogadoebis janmrTelobis interesebs, xels uSlis eqims,
daicvas profesiuli da eTikuri standartebi.
1.4.6 profesiis prestiJi
profesiis Rirsebisa da prestiJis dacva eqimis saqmianobis
aucilebeli Semadgenelia. is, upirveles yovlisa, miiRweva
keTilsindisieri profesiuli saqmianobiT, eTikuri da
profesiuli standartebis ganuxreli dacviT, sxva eqimebTan
kolegialuri damokidebulebiT, pacientisa da sazogadoebis
janmrTelobis interesebze gulwrfeli zrunviT.
11
2. kerZo nawili
2.1. eqimis damokidebuleba pacientTan profesiuli movaleobis
aRsrulebisas
eqimis upirvelesi sazrunavia pacienti – adamiani, romelic
eqims mimarTavs janmrTelobis problemis gamo. eqimi yovelTvis
unda iTvaliswinebdes, rom mas saqme aqvs ara mxolod
daavadebasTan, aramed pirovnebasTan, romelsac sakuTari
faseulobebi, Sexedulebebi da molodini aqvs, Taviseburad
ganicdis da aRiqvams avadmyofobas.
warmatebuli saeqimo saqmianobis aucilebeli winapirobaa
eqimsa da pacients Soris urTierTgagebis, urTierTndobisa da
urTierTpativiscemis atmosferos Camoyalibeba, partnioruli
urTierTobis damyareba.
2.1.1 pacientis avtonomiis pativiscema
pacientis, rogorc pirovnebis, pativiscema aucileblad
gulisxmobs misi azris, Sexedulebebisa da arCevanis
gaTvaliswinebas, rac pacientis avtonomiis aRiarebas niSnavs.
pativi eciT pacientis avtonomias – pacientis uflebas,
miiRos informirebuli gadawyvetileba misTvis samedicino
daxmarebis gawevis Taobaze.
2.1.2 Tanabari da samarTliani damokidebuleba
Tanabari da samarTliani damokidebuleba pacientis mimarT
gulisxmobs, erTi mxriv, yovelgvari diskriminaciis gamoricxvas,
xolo, meore mxriv, pacientis individualuri saWiroebebis
gaTvaliswinebas.
dauSvebelia eqimis mier pacientis diskriminacia
warmomavlobis, socialuri mdgomareobis, aRmsareblobis,
msoflmxedvelobis, daavadebis an sxva raime niSnis gamo.
amasTan, pacientisTvis samedicino daxmarebis gawevisas
gaiTvaliswineT misi individualuri saWiroebebi, rogorc
janmrTelobasTan, ise religiur, eTnikur, fsiqologiur,
socialur Tu sxva pirovnul maxasiaTeblebTan dakavSirebuli.
12
2.1.3 informaciis miwodeba
2.1.3.1 informaciis miwodeba pacientisaTvis
pacients ufleba aqvs misTvis gasageb enaze da misTvis
gasagebi formiT miiRos obieqturi, sruli, drouli informacia
sakuTari janmrTelobis mdgomareobis Sesaxeb.
hkiTxeT pacients, surs Tu ara sakuTari janmrTelobis
mdgomareobis Sesaxeb sruli informaciis miReba. survilis
SemTxvevaSi, miawodeT pacients misTvis gasagebi formiT
amomwuravi, obieqturi da drouli informacia:
§ samedicino gamokvlevebis Sedegebis, diagnozisa da
prognozis, SeTavazebuli prevenciuli, sadiagnozo,
samkurnalo Tu sareabilitacio RonisZiebebis, agreTve, maTi
Tanmxlebi riskisa da SesaZlo efeqtianobis Sesaxeb;
§ zemoxsenebuli SeTavazebuli RonisZiebebis alternatiuli
variantebis, maTi Tanmxlebi riskisa da SesaZlo
efeqtianobis Sesaxeb;
§ samedicino momsaxurebasTan dakavSirebuli finansuri
sakiTxebis, samedicino dawesebulebis resursebisa da
Sinaganawesis Taobaze;
§ Tqveni (mkurnali eqimis) vinaobisa da kompetenciis Sesaxeb.
pacientis informirebisas gaiTvaliswineT misi aRqmis unari,
nu gamoiyenebT samedicino terminebs. darwmundiT, rom man
jerovnad gaigo da Seafasa Tqvens mier miwodebuli informacia.
Tu pacienti arasrulwlovania, ixelmZRvaneleT TavSi `2.2.1
arasrulwlovnebi~ asaxuli rCevebiT.
Tu pacients gadawyvetilebis miRebis unari SezRuduli aqvs
fsiqikuri daavadebis gamo, ixelmZRvaneleT rCevebiT, romlebic
mocemulia TavSi `2.2.5 eqimi da fsiqikuri daavadebis mqone
pacientebi, romlebsac SezRuduli aqvT gadawyvetilebis miRebis
unari~.
13
Tu pacienti uars ambobs informaciis miRebaze, dahyeviT mis
nebas da hkiTxeT, vis SeiZleba miawodoT informacia (naTesavi,
kanonieri warmomadgeneli; ix. Tavi `2.1.3.2 informaciis miwodeba
pacientis axloblisTvis an kanonieri warmomadgenlisTvis~).
amasTan, im SemTxvevaSi, Tu pacienti uars ambobs informaciis
miRebaze, magram informaciis miuwodeblobam SeiZleba ziani
miayenos Tavad pacientis an mesame piris janmrTelobas, romlis
vinaobac cnobilia, maSin Tqven mainc unda miawodoT pacients
informacia.
Tu pacienti gTxovT samedicino Canawerebis gacnobas,
daubrkoleblad mieciT mas amisi SesaZlebloba.
roca pacientma ar icis saxelmwifo da/an eqimisTvis gasagebi
ena, ixelmZRvaneleT kanonmdeblobiT da dawesebulebis
SinaganawesiT, romelic gansazRvravs Tarjimnis mowvevisa da
anazRaurebis wess.
Tu Tqven grZnobT, rom enobrivi barieris gamo ar SegiZliaT
srulyofili informaciis moZieba, gaagzavneT pacienti sxva
eqimTan, romelic SeZlebs moxseniebuli dabrkolebis daZlevas.
aRniSnulis SeuZleblobis SemTxvevaSi, pacientis janmrTelobis
interesebidan gamomdinare, uari TqviT samedicino momsaxurebaze,
kanonmdeblobiT daSvebul SemTxvevebSi (ix. Tavi `2.1.13 eqimis
uari samedicino momsaxurebis gawevaze~).
Tu Tqven gaqvT safuZveli ivaraudoT, rom janmrTelobis
mdgomareobis Sesaxeb informaciis miwodebam SeiZleba uaryofiTi
gavlena iqonios pacientis mdgomareobaze:
§ SezRudeT informaciis moculoba an saerTod nu miawodebT
informacias;
§ zemoT miTiTebul gadawyvetilebas individualurad nu
miiRebT; aucileblad SeajereT is Tqveni dawesebulebis
eTikis komisiasTan an, misi ararsebobis SemTxvevaSi, Tqvens
kolegasTan;
14
§ rogorc erT, ise meore zemoxsenebul SemTxvevaSi pacientis
samedicino dokumentaciaSi werilobiT daasabuTeT
informaciis armiwodebis an SezRudvis saWiroeba da
gadawyvetileba; agreTve, daafiqsireT samedicino eTikis
komisiis an kolegis Tanxmoba;
§ Tu pacienti daJinebiT moiTxovs misTvis sruli informaciis
miwodebas, maT Soris samedicino Canawerebis gacnobas, Tqven,
miuxedavad zemoT moxseniebuli garemoebisa, valdebuli
xarT, mas sruli informacia miawodoT.
2.1.3.2 informaciis miwodeba pacientis axloblisTvis an kanonieri warmomadgenlisTvis
§ qmedunariani pacientis janmrTelobis Sesaxeb informacia mis
kanonier warmomadgenels an naTesavs miawodeT mxolod im
SemTxvevaSi, Tu Tqven amis Taobaze pacientisgan Tanxmoba
miiReT. amasTan, pacientma Tavad unda daasaxelos im piris
vinaoba, romelsac informacias miawodebT;
§ Tu pacienti qmeduunaroa an ar aqvs gacnobierebuli
gadawyvetilebis miRebis unari, informacia miawodeT
pacientis kanonier warmomadgenels an naTesavs.
2.1.4 informirebuli Tanxmoba, pacientis gadawyvetilebis pativiscema
informirebuli Tanxmoba samedicino Carevis aucilebeli
pirobaa; is uzrunvelyofs samedicino Carevis Sesaxeb
gadawyvetilebis miRebaSi pacientis Tanamonawileobas.
pacientis informirebuli Tanxmoba ama Tu im samedicino
Carevaze gulisxmobs misi Tanxmobis miRebas mxolod mas Semdeg,
rac pacients detalurad ganemarta:
§ ra saxis Carevaa ganzraxuli;
§ ratom sWirdeba pacients es Careva;
§ rogoria ganzraxuli Carevis mosalodneli Sedegi, ra
diskomforti, garTulebebi aris SesaZlebeli, rogoria
riski pacientis janmrTelobisa da sicocxlisTvis;
§ ra Sedegi SeiZleba mohyves ganzraxul Carevaze uaris Tqmas;
15
§ ganzraxuli Carevis ra alternativebi arsebobs, ramdenad
xelmisawvdomia es Carevebi teritoriulad, finansurad; ra
upiratesoba an nakli aqvs maT, ganzraxul CarevasTan
SedarebiT.
zemoT miTiTebuli informaciis miwodebisas esaubreT
pacients misTvis gasagebi eniT, samedicino terminebis
gamoyenebis gareSe, ise, rom man kargad gaigos da Seafasos
miwodebuli informacia.
informirebuli Tanxmobis aucilebeli pirobaa pacientis
qmedunarianoba da gacnobierebuli gadawyvetilebis miRebis
unari. Tu pacienti qmeduunaroa an moklebulia gacnobierebuli
gadawyvetilebis miRebis unars, ixelmZRvaneleT rekomendaciebiT,
romlebic asaxulia TavebSi `2.2.1 arasrulwlovnebi~ da `2.2.5
eqimi da fsiqikuri daavadebis mqone pacientebi, romlebsac
SezRuduli aqvT gadawyvetilebis miRebis unari~.
amasTan, gaiTvaliswineT, rom:
§ pacientis Tanxmoba samedicino Carevaze unda iyos
Tavisufali1;
§ saqarTvelos kanonmdebloba zogierTi samedicino
CarevisaTvis aucileblad miiCnevs werilobiT informirebul
Tanxmobas2.
werilobiTi informirebuli Tanxmoba aucilebelia
qirurgiuli operaciebis, sxva invaziuri da maRal riskTan
dakavSirebuli procedurebis SemTxvevaSi (mag., sxivuri Terapia,
qimioTerapia, genetikuri testireba da sxva). amasTan, SegiZliaT,
Tqveni Sexedulebisamebr, nebismier SemTxvevaSi miiRoT
pacientisagan werilobiTi informirebuli Tanxmoba.
1 Tavisufali Tanxmoba – Tanxmoba, miRebuli yovelgvari zewolis, zegavlenis (fsiqologiuri, finansuri da sxv.) gareSe. 2 saqarTvelos kanoni `saeqimo saqmianobis Sesaxeb ~, muxli 44.1
16
2.1.4.1 pacientis uari samedicino momsaxurebis gawevaze pacients SeuZlia uari Tqvas nebismier samedicino Carevaze.
kanoni krZalavs qmedunariani da gacnobierebuli gadawyvetilebis
unaris mqone pacientis nebis winaaRmdeg raime samedicino Carevas.
roca pacienti uars acxadebs samedicino momsaxurebaze, ama
Tu im samedicino Carevaze, darwmundiT, rom pacients kargad
esmis am Carevis mizani, mniSvneloba, mosalodneli sargebloba da
riski, misi (samedicino Carevis) arCatarebis mosalodneli
Sedegebi; meore mxriv, kargad SeafaseT pacientis mier
gacnobierebuli gadawyvetilebis miRebis unari. am ukanasknelis
kritikuli Sefaseba gansakuTrebiT mniSvnelovania, roca pacienti
uars ambobs misi janmrTelobisa da sicocxlisaTvis
mniSvnelovan Carevaze.
roca samedicino momsaxurebaze uars acxadebs pacienti
ganukurnebeli daavadebis terminaluri stadiiT, ixelmZRvaneleT
rekomendaciebiT, romlebic asaxulia TavSi `2.2.5 pacienti
ganukurnebeli daavadebis terminalur stadiaze, paliatiuri
mzrunveloba, tkivilis marTva~.
2.1.4.2 pacientis winaswar gacxadebuli neba
saqarTvelos kanonmdeblobiT moqlaqes SeuZlia winaswar
werilobiT gamoxatos neba misTvis samedicino momsaxurebis
gawevis Sesaxeb im SemTxvevebSi, roca is ver SeZlebs sakuTari
nebis gamoxatvas (mag., aRmoCndeba komur mdgomareobaSi).
saqarTveloSi jerjerobiT ar arsebobs pacientebis winaswar
gacxadebuli nebis registri. amitom, zemoaRniSnulis Sesaxeb
hkiTxeT pacientis ojaxis wevrebs, axloblebs. aseTi werilobiTi
dokumentis arsebobis SemTxvevaSi, gaiTvaliswineT pacientis
survili misTvis samedicino momsaxurebis gawevis Sesaxeb, magram
gaxsovdeT, rom aseTi neba ar SeiZleba exebodes sicocxlis
SemanarCunebeli mkurnalobis Sewyvetas an arCatarebas, garda im
SemTxvevebisa, roca pacients aqvs fataluri an mZime invalidobis
gamomwvevi daavadeba.
17
2.1.5 informaciis konfidencialuroba
pacientis janmrTelobis mdgomareobisa da piradi cxovrebis
Sesaxeb informacia konfidencialuria. Tqven ar unda gaamJRavnoT
is arc pacientis sicocxleSi da arc misi sikvdilis Semdeg.
dauSvebelia konfidencialuri informaciis gamJRavneba
masobrivi informaciis saSualebebis warmomadgenlebisaTvis.
konfidencialuri informaciis gamJRavneba SeiZleba, Tu:
§ pacienti Tanaxmaa, rom misi janmrTelobis mdgomareobisa Tu
piradi cxovrebis Sesaxeb informacia gadaeces sxva pirs an
pirebs;
§ informaciis gaumJRavnebloba safrTxes uqmnis mesame piris
(romlis vinaobac cnobilia) janmrTelobas an/da sicocxles;
§ informacia miewodeba samedicino momsaxurebaSi CarTul sxva
samedicino personals;
§ Tqven gaqvT dasabuTebuli eWvi savaldebulo aRricxvas
daqvemdebarebuli daavadebis arsebobaze;
§ informacias, werilobiTi momarTvis safuZvelze, iTxovs
sasamarTlo an prokuraturis organoebi;
§ es gaTvaliswinebulia Sesabamisi kanonmdeblobiT.
rogorc zemoT aris miTiTebuli, pacientis Sesaxeb
konfidencialuri informacia kolegas gauziareT mxolod maSin,
Tu igi CarTulia pacientisaTvis samedicino daxmarebaSi;
magaliTad, rodesac kolegasTan agzavniT pacients an kolega
raRac etapze ukve monawileobda pacientisaTvis samedicino
momsaxurebaSi, agreTve, yvela sxva SemTxvevaSi, roca TvliT, rom
misi rCeva mniSvnelovania konkretuli pacientis samedicino
problemis marTvisaTvis.
amasTan, aRniSnul SemTxvevebSi, kolegasTan pirispir Tu
satelefono saubrisas, darwmundiT, rom aravin gismenT (mag., ar
xarT sxvaTa garemocvaSi). aseve, gaufrTxildiT samedicino
Canawerebs, faqsiT Tu eleqtronuli fostiT miRebul
18
informacias, konsultantebis Canawerebs da uzrunvelyaviT maTi
dacva ise, rom isini ar iyos xelmisawvdomi SemTxveviTi
pirebisTvis.
nuravis gaumJRavnebT informacias pacientis ojaxuri
cxovrebis intimuri detalebis Sesaxeb, pacientis sikvdilis
Semdegac ki.
2.1.6 pirad cxovrebaSi Caurevloba
pacientisaTvis mniSvnelovania, rom ambulatoriasa Tu
saavadmyofoSi hqondes garkveulwilad izolirebuli, daculi
garemo da samedicino momsaxurebis miRebisas `moridebuli iyos
ucxo Tvals~.
pativi eciT pacientis am survils; Sesabamisad, konsultacias
an ama Tu im samedicino proceduras nuravis daaswrebT, garda im
SemTxvevebisa, roca pacienti Tavad iTxovs amas (axlobeli,
ojaxis wevri da sxv.) an Tu TvliT, rom aucilebelia sxva
samedicino personalis, studentebis an rezidentebis daswreba da
monawileoba. yvela SemTxvevaSi pacients acnobeT, vin da ratom
aris mowveuli da miiReT misgan Tanxmoba.
zogjer erTi-erTze saubari da pacientis gasinjva
izolirebul garemoSi SeuZlebelia samedicino dawesebulebaSi
arsebuli pirobebis gamo – mravalsawoliani palata, intensiuri
Terapiis ganyofileba. aseT SemTxvevaSi SeecadeT, maqsimalurad
uzrunvelyoT pacientisaTvis komfortuli garemo (mag., Sirmis
gamoyeneba); am dros pacients esaubreT SeZlebisdagvarad
xmadabla, ise, rom Tqveni saubari mxolod misTvis iyos gasagoni.
2.1.7 pacientis monawileoba studentebis, rezidentebis, eqimebis swavlebasa da mzadebaSi
pacientis monawileoba studentebis, rezidentebis, eqimebis
swavlebasa da mzadebaSi samedicino praqtikis aucilebeli
Tanamdevi procesia.
ganumarteT pacients, risTvis aris saWiro studentebis,
rezidentebis da/an sxva eqimebis daswreba pacientis fizikuri
gasinjvisas, romelime samedicino proceduris (qirurgiuli
19
Carevis CaTvliT) an sxvaTa mier Catarebuli konsultaciisas.
pacientis Tanxmoba am SemTxvevebSi aucilebelia.
SeecadeT, rom xsenebulTa daswrebam minimaluri diskomforti
Seuqmnas pacients. proceduris damTavrebisas madloba
gadauxadeT mas keTili nebisaTvis.
Tu pacienti qmeduunaroa an SezRuduli aqvs qmedunarianoba,
an moklebulia gacnobierebuli gadawyvetilebis miRebis unars,
werilobiTi informirebuli Tanxmoba unda miiRoT pacientis
naTesavisgan an axloblisagan.
swavlebis mizniT (leqcia, seminari, SemTxvevis garCeva da a.S.)
pacientis janmrTelobis mdgomareobis amsaxveli dokumentaciis
gamoyenebisas monacemebi warmoadgineT ise, rom SeuZlebeli iqnes
pirovnebis identificireba.
2.1.8 holistikuri midgoma: pacientTan urTierTobis biofsiqosocialuri modeli
pacientis janmrTelobasTan dakavSirebuli problemebis (anu
biosamedicino problemebis) gadaWrisas gaiTvaliswineT pacientis
fsiqologiuri maxasiaTeblebi da im socialuri garemos
Taviseburebebi, romelSic pacienti cxovrobs (ojaxi, samsaxuri
da a.S.).
moxseniebuli mniSvnelovani winapirobaa Tqveni
rekomendaciebis rigianad Sesasruleblad da, aqedan gamomdinare,
efeqturi samedicino momsaxurebisaTvis, pacientis
kmayofilebisaTvis. SeecadeT pasuxi miiRoT kiTxvebze:
§ rogoria daavadebis pacientiseuli aRqma da gancda? rogor
afasebs pacienti Tavis janmrTelobas da daavadebas? xom ar
aqvs gadaWarbebuli SiSi, SfoTva an zerelad xom ar
aRiqvams Tavis problemebs?
§ rogor zrunavs sakuTar janmrTelobaze? ras moelis
eqimisagan da jandacvis sistemisgan?
§ ramdenad SeTavsebadia Tqveni rekomendaciebi:
20
o pacientis qceviT maxasiaTeblebTan (organizebuloba,
akuratuloba, Cvevebi, tradiciebi da a.S.)?
o mis mikrosocialur garemosTan (ojaxis wevrebi, maTi
damokidebuleba pacientisadmi, sacxovrebeli pirobebi,
vin hyavs gverdiT, vin SeiZleba daexmaros eqimis
daniSnulebis da rCevebis SesrulebaSi)?
§ ramdenad xelmisawvdomia misTvis (finansurad,
teritoriulad, teqnikurad da sxv.) Tqvens mier
rekomendebuli prevenciuli, sadiagnozo, samkurnalo Tu
sareabilitacio RonisZiebebi?
zemoxsenebul kiTxvebze pasuxebis gaTvaliswineba
gagiadvilebT pacientisaTvis misaRebi da Sesrulebadi
rekomendaciebis Camoyalibebas, pacientis CarTvas
gadawyvetilebis miRebisa da misi realizaciis procesSi.
2.1.9 eqimi – komunikaciis eqsperti
pacientze orientirebuli, efeqturi komunikacia
gulisxmobs pacientisadmi gulwrfeli TanagrZnobis, Tanadgomis
gamoxatvas, Ria, gaxsnil, gulisxmier, zrdilobian urTierTobas
misi ndobis mosapoveblad.
eqimi pacientTan misalmebisa da gamomSvidobebis dros iqceva
ise, rogorc es miRebulia zogadad sazogadoebaSi, amave dros,
konkretuli pacientis individualuri maxasiaTeblebis
gaTvaliswinebiT. es, upirveles yovlisa, gulisxmobs wamodgomas
migebebisa da gamomSvidobebis dros.
mieciT pacients saubris dro da saSualeba; acadeT, srulad
gamoxatos Tavisi azri, gancda daavadebis Taobaze, SfoTvebi da
molodini; reagirebis gareSe nu datovebT pacientis emocias.
esaubreT pacients mkafiod da misTvis gasagebi eniT, SeafaseT
ramdenad aRiqvams is Tqvens naTqvams.
ecadeT, CamouyaliboT pacients motivacia cxovrebis niris
Sesacvlelad, samkurnalo sqemis guldasmiT Sesasruleblad,
sakuTar janmrTelobaze zrunvisaTvis.
21
konsultaciis procesSi nu iqnebiT dakavebuli samedicino
Canawerebis warmoebiT. ecadeT, gqondeT TvaliT kontaqti (uyureT
pacients); saWiroebisamebr, isargebleT araverbaluri
komunikaciis sxva meTodebiT (eqimis poza, manZili eqimsa da
pacients Soris da sxv.). gaxsovdeT, rom `araverbaluri
gzavnilebis” gamoyeneba xSirad ufro metad moqmedebs pacientze,
vidre sityva.
2.1.10 eqimi rogorc pacientis maswavlebeli
pacientisaTvis aRmoCenili samedicino daxmarebis erT-erTi
mniSvnelovani nawilia pacientis ganaTleba mis janmrTelobasTan
dakavSirebul (daavadebaTa prevencia, mkurnaloba, reabilitacia)
sakiTxebSi. pacientis ganaTleba xels uwyobs Tqvensa da
pacients Soris TanamSromlobis – e.w. `Terapiuli aliansis”
Camoyalibebas. is aucilebeli winapirobaa imisaTvis, rom pacienti
daavadebis marTvis monawile gaxdes da ar darCes mxolod eqimis
miTiTebebis brmad da usityvod Semsruleblad; moxseniebuli
mniSvnelovanwilad aris samedicino momsaxurebis efeqturobis
safuZveli.
yovelTvis ganumarteT pacients misi roli sakuTari
janmrTelobis SenarCunebasa da gaumjobesebaSi; ra unda
gaakeTos, ratom unda Seasrulos Tqveni rekomendaciebi.
moxseniebuls didi mniSvneloba aqvs pacientisaTvis motivaciis
SeqmnisaTvis.
SeecadeT, Tqveni rekomendaciebi iyos konkretuli,
pacientisaTvis gasagebi da Sesrulebadi.
amasTan, pacientisaTvis informaciis miwodebisas cxovrebis
jansaRi wesis Taobaze gaiTvaliswineT is iSviaTi SemTxvevebic,
roca pacientma Tqveni rCeva SeiZleba pirad cxovrebaSi Carevad
aRiqvas. sxva SemTxvevaSi moxseniebuli informacia misTvis ama Tu
im mavne CveviT ganpirobebuli daavadebis aRmocenebis SiSis
gaCenis da sulieri simSvidis darRvevis mizezi SeiZleba gaxdes
(iatrogenia). am dros janmrTeli adamiani sakuTar sxeulSi
iwyebs safrTxis niSnebis Ziebas. aseT SemTxvevebSi SeecadeT
22
daarwmunoT pacienti, rom mas arafers umalavT da Tqveni mizania
mxolod cxovrebis jansaRi wesis propaganda da misive
janmrTelobis dacva.
igive garemoebebia gasaTvaliswinebeli avTvisebianis simsivnis
skriningis Sesaxeb rekomendaciebis micemisas.
2.1.11 eqimi da rTuli pacienti
rTuli pacientis damaxasiaTebelia disforiuli depresia,
mometebuli SfoTva an agresiuloba.
sirTule SeiZleba dakavSirebuli iyos fsiqiatriul
problemasTan, personologiur, qceviT TaviseburebebTan.
imavdroulad, pacientTan urTierTobis siZnele Tavad eqimis
gamoucdelobiT, komunikaciis unar-Cvevebisa da moulodnel da
araadekvatur reaqciebTan gamklavebis unaris arasrulyofilebiT
SeiZleba iqnes ganpirobebuli; agreTve, eqimis gadatvirTulobiT,
daRlilobiT da sxva pirovnuli garemoebebiT. udavo mniSvneloba
aqvs jandacvis sistemis naklovanebebsac; am ukanaskneliT
gamowveuli ukmayofileba pacients eqimze gadaaqvs, rac arTulebs
pacientsa da eqims Soris urTierTobas. sistemasTan
dakavSirebuli naklovanebebi gulisxmobs eqimis zedmiwevniT
gadatvirTvas, cvlilebebs jandacvis dafinansebaSi, sadazRvevo
paketiT Tu sxva ram mizeziT ganpirobebul vizitebis arasakmaris
sixSires. moxseniebuli aryevs eqimis avtoritets.
guldasmiT SeafaseT rTuli pacienti fsiqopaTologiis
aRmosaCenad. dasaxmareblad moixmeT kolegebi. specifikuri
sakomunikacio teqnika da pacientis SeZlebisdagvarad
maqsimaluri CarTuloba procesSi aumjobesebs urTierTobas.
rTul pacientTan urTierTobisas:
§ mouxmeT kolegas, erTad gansajeT situacia; Tu saWirod
CaTvliT, daixmareT fsiqoTerapevti;
§ gamohyaviT aseTi pacientis vizitisaTvis Cveulebrivze meti
dro;
23
§ saTanadod daafiqsireT sirTulis komponentebi samedicino
dokumentaciaSi; aucileblad aRnusxeT sirTuleebis
daZlevis Tqveneuli mcdelobebi, maTi Sedegianoba Tu
uSedegoba.
2.1.12 momsaxurebis uwyvetoba, momsaxurebaSi sxva personalis CarTva
samedicino momsaxurebis uwyvetoba gulisxmobs aucilebeli
prevenciuli, sadiagnozo, samkurnalo Tu sareabilitacio
RonisZiebebis Seuferxebel ganxorcielebas, rogorc erTi
samedicino dawesebulebis farglebSi erTi an ramdenime
medicinis muSakis mier, aseve, sxva dawesebulebebSi sxvadasxva
specialistebis koordinirebuli TanamSromlobis safuZvelze.
Tqveni SesaZleblobebis farglebSi, yvela Rone ixmareT
momsaxurebis wyvetis gamomwvevi SesaZlo mizezebis (finansuri,
organizaciuli, pirovnuli da a.S.) aRmosafxvrelad.
Tu samedicino momsaxurebis uwyvetobis uzrunvelsayofad
saWirod migaCniaT sxva samedicino personalis CarTva
momsaxurebis procesSi:
a) ganumarteT pacients, ratom aris saWiro sxva samedicino
personalis CarTva;
b) miawodeT pacients mkafio, misTvis gasagebi informacia
aucilebeli samedicino momsaxurebis Sesaxeb – ra
gamokvlevebi, konsultaciebi, samkurnalo, prevenciuli Tu
sareabilitacio RonisZiebebia misTvis aucilebeli da ra
vadebSi; daixmareT pacientis axloblebi (amisTvis pacientis
Tanxmobaa saWiro), Tu varaudobT, rom es xels Seuwyobs
pacientis mier zemoxsenebuli informaciis srulfasovnad
aRqmas da Sefasebas;
g) awarmoeT mkafio samedicino Canawerebi (samedicino baraTi,
sakonsultacio furceli, daskvnebi, cnobebi, amonawerebi da
sxv.), organizebuli, sistemuri saxiT, ise, rom maTi moZieba
da gacnoba advili iyos kolegebisTvis;
24
d) SeecadeT daukavSirdeT kolegas (Tu is sxva dawesebulebaSi
muSaobs), romelic CarTulia an unda CaerTos Tqveni
pacientis samedicino momsaxurebaSi. yvela SemTxvevaSi
werilobiT ganumarteT kolegas pacientis gagzavnis mizani
da janmrTelobis problemis arsi;
e) roca pacients iRebT sxva eqimis momarTviT, romelSic
miTiTebulia konsultaciis mizani, SeecadeT sakonsultacio
baraTSi mkafiod asaxoT miznis Sesabamisi informacia,
agreTve, yvela monacemi, romelic, Tqveni azriT,
sayuradReboa pacientis janmrTelobisaTvis;
v) Tu raime mizezis gamo ar gaqvT pacientisaTvis samedicino
momsaxurebis gawevis da/an misi uwyvetobis uzrunvelyofis
SesaZlebloba, auxseniT mas, vis da rogor SeuZlia mimarTos.
amasTan, uzrunvelyaviT kolegisaTvis (vinc, savaraudod,
pacients samedicino momsaxurebas gauwevs) samedicino
Canawerebis xelmisawvdomoba;
z) dauSvebelia raime sazRauris an sxva sargeblis moTxovna an
miReba im eqimisgan, an eqimis funqciis Semsruleblisgan,
romlis CarTva pacientis momsaxurebis procesSi Tqven
ganizraxeT;
sxva samedicino personalis momsaxurebaSi CarTvis formebia:
§ delegireba;
§ referali;
§ gadabareba.
delegireba gulisxmobs:
a) kolegisTvis Txovnas, gauwios pacients Tqvens mier
gansazRvruli, TqvenTan SeTanxmebuli samedicino momsaxureba.
delegirebis adekvaturobisaTvis, momsaxurebis xarisxisa da
SedegisaTvis pasuxismgebloba Tqven gekisrebaT, TumcaRa gaweuli
momsaxurebis (manipulacia an sxva raime qmedeba) xarisxisaTvis da
SedegisaTvis pasuxs agebs ganmaxorcielebelic;
25
b) eqimis funqciis SemsrulebelisaTvis (studenti, rezidenti)
Txovnas gauwios pacients Tqvens mier gansazRvruli, TqvenTan
SeTanxmebuli samedicino momsaxureba. delegirebis
adekvaturobisaTvis, momsaxurebis xarisxisa da SedegisaTvis
pasuxismgebloba Tqven gekisrebaT.
referali gulisxmobs sxva eqimisTvis da/an samedicino
dawesebulebisTvis pacientis gagzavnas garkveuli mizniT da
garkveuli droiT (roca ar gagaCniaT saTanado resursi, marTva
scildeba Tqveni profesiuli kompetenciis farglebs da sxv.),
pacientis janmrTelobis problemis marTvisaTvis
pasuxismgeblobis nawilobriv an mTlianad gadacemiT.
gadabareba gulisxmobs pacientis janmrTelobis problemis
marTvisTvis pasuximgeblobis srulad gadacemas sxva
profesionalisaTvis.
yvela zemoxsenebul SemTxvevaSi:
§ kolegas Tu samedicino dawesebulebas sruli informacia
unda miawodoT pacientis janmrTelobis mdgomareobisa da
misTvis ukve gaweuli samedicino momsaxurebis Sesaxeb;
§ darwmunebuli unda iyoT, rom saWiro momsaxureba
ganxorcieldeba momsaxurebis gasawevad aucilebeli drois
ganmavlobaSi;
§ unda gqondeT dasabuTebuli varaudi, rom uzrunvelyofili
iqneba momsaxurebis usafrTxoeba da xarisxi.
2.1.13 eqimis uari samedicino momsaxurebis gawevaze, samedicino momsaxurebis Sewyveta
yovelTvis, roca uars ambobT an wyvetT samedicino
momsaxurebas, Tuki es SesaZlebelia, acnobeT pacients
(saWiroebisas, mis kanonier warmomadgenels an naTesavs)
samedicino momsaxurebis gawevaze uaris Tqmis an dawyebuli
samedicino momsaxurebis Sewyvetis mizezi.
26
2.1.13.1 eqimis profesiul kompetenciasTan da resursebis ukmarisobasTan dakavSirebuli uari
samedicino momsaxurebis dawyebamde kritikulad SeafaseT
Tqveni profesiuli kompetencia, Tqvens xelT arsebuli resursebi
da uari TqviT momsaxurebaze, Tu:
§ is scildeba Tqveni specialobis farglebs an Seesabameba
Tqvens specialobas, magram ar eTanadeba Tqvens codnas da
unar-Cvevebs;
§ adekvaturi momsaxurebisa da xarisxis uzrunvelyofisaTvis
aucilebeli pirobebi da/an resursebi ar gagaCniaT.
zemoaRniSnuli ar exeba pacientisaTvis gadaudebeli
samedicino daxmarebis gawevas (ix. Tavi `2.3 gadaudebeli
samedicino momsaxureba~).
profesiuli kompetenciis, agreTve, Sesabamisi pirobebisa da
resursebis ukmarisobis gamo pacientisaTvis samedicino
momsaxurebis gawevaze uaris Tqmis an momsaxurebis Sewyvetis
SemTxvevaSi urCieT pacients, vis, sad da rogor unda mimarTos
misTvis saWiro samedicino momsaxurebis misaRebad, agreTve,
uzrunvelyaviT pacientis janmrTelobis Sesaxeb Tqvens xelT
arsebuli informaciis xelmisawvdomoba sxva samedicino
personalisaTvis, romelic gauwevs pacients momsaxurebas;
amasTan, ixelmZRvaneleT TavSi `2.1.12 momsaxurebis uwyvetoba,
momsaxurebaSi sxva personalis CarTva~ asaxuli rekomendaciebiT.
2.1.13.2 samedicino da eTikur kriteriumebTan an akrZalvasTan dakavSirebuli uari
uari TqviT samedicino Carevaze:
§ romelic kanonmdeblobiT akrZalulia;
§ romlis Catareba samedicino kriteriumebiT
gaumarTlebelia da/an ar Seesabameba eTikur normebs,
miuxedavad imisa, vin gTxovT aseTi Carevis ganxorcielebas.
2.1.13.3 eqimis usafrTxoebasTan dakavSirebuli uari
Tqven SegiZliaT uari TqvaT pacientis samedicino
momsaxurebaze an SewyvitoT ukve dawyebuli samedicino
27
momsaxureba, Tu momsaxurebis dros Tqvens sicocxles realuri
safrTxe Seeqmna (mag. xanZari, eleqtrotravmis an afeTqebis
saSiSroeba da sxv.).
amasTan, Tqveni SesaZleblobebis farglebSi, SeecadeT,
uzrunvelyoT pacientisaTvis samedicino daxmarebis gasawevad
saWiro pirobebi; amisaTvis dauyovnebliv daukavSirdiT da
gamoiZaxeT Sesabamisi samsaxurebi (saxanZro-samaSvelo samsaxuri,
policia da a.S.). pacients daxmareba aRmouCineT, rogorc ki amisi
SesaZlebloba mogecemaT.
2.1.13.4 eqimis moralur SexedulebebTan dakavSirebuli uari
Tqven SegiZliaT uari TqvaT samedicino Carevaze, roca
aRniSnuli samedicino Careva kanonmdeblobiT daSvebulia, magram
ewinaaRmdegeba Tqvens moralur faseulobebs.
zemoaRniSnuli ar exeba pacientisaTvis gadaudebeli
samedicino daxmarebis gawevas (ix. Tavi `2.3 gadaudebeli
samedicino momsaxureba~).
Tu Tqven, Tqveni moraluri Sexedulebebis gamo, saerTod
uars ambobT ama Tu im samedicino Carevis ganxorcielebaze, amis
Sesaxeb winaswar acnobeT dawesebulebis xelmZRvanels,
saWiroebisas, sadazRvevo kompanias da/an jandacvis marTvis
adgilobriv struqturas da Tqvens pacientebs.
2.1.13.5 samedicino momsaxurebis Sewyveta da pacientTan profesiuli urTierTobis dasruleba pacientis qcevis gamo
zogjer pacientis qcevis gamo (agresiuloba, Zaladoba,
qurdoba, araadekvaturi qmedeba) SeuZlebeli xdeba pacientTan
profesiuli urTierTobis gagrZeleba da misTvis samedicino
momsaxurebis gaweva.
sanam pacientTan profesiuli urTierTobis gawyvetis Sesaxeb
gadawyvetilebas miiRebdeT, SeecadeT normaluri komunikaciis
aRdgenas, hkiTxeT rCeva kolegas, xelmZRvanels; amasTan,
ixelmZRvaneleT rekomendaciebiT, romlebic asaxulia TavSi `2.1.11
eqimi da rTuli pacienti~.
28
pacientTan profesiuli urTierTobis dasrulebis Sesaxeb
gadawyvetileba kargad daasabuTeT; acnobeT pacients aRniSnulis
Sesaxeb, umjobesia werilobiT, urTierTobis dasrulebis
mizezebis aRniSvniT.
acnobeT pacients, sad SeuZlia samedicino momsaxurebis
gagrZeleba da uzrunvelyaviT pacientis janmrTelobis Sesaxeb
Tqvens xelT arsebuli informaciis (upirveles yovlisa,
samedicino Canawerebis) xelmisawvdomoba im samedicino
personalisaTvis, romelic gaagrZelebs pacientis samedicino
momsaxurebas; amasTan, ixelmZRvaneleT TavSi `2.1.12 momsaxurebis
uwyvetoba, momsaxurebaSi sxva personalis CarTva~ asaxuli
rekomendaciebiT.
2.2. eqimi da sazogadoebis daucveli, mowyvladi nawili
2.2.1 arasrulwlovnebi
arasrulwlovani pacientis SemTxvevaSi gadawyvetilebis
mimRebia mSobeli an meurve/kanonieri wamomadgeneli. Sesabamisad,
maTi Tanxmobis misaRebad Tqven unda imoqmedoT ise, rogorc
moqmedebT pacientisgan Tanxmobis miRebis SemTxvevaSi (ix. Tavi
`2.1.4 informirebuli Tanxmoba, pacientis gadawyvetilebis
pativiscema~). imavdroulad, SeecadeT, arasrulwlovani, misi
asakis, gonebrivi ganviTarebis Sesabamisad, gadawyvetilebis
miRebisas Tanamonawiled gaxadoT da gaiTvaliswinoT misi azri
samedicino Carevaze.
zemoxsenebulidan gamomdinare, arasrulwlovnebTan
urTierToba damatebiT moTxovnebs uyenebs eqims. es imiTia
ganpirobebuli, rom xSirad rTulia balansis dacva qvemoT
CamoTvlil sam komponents Soris:
§ arasrulwlovnis interesebi da molodini, mis SegrZnebebi
da emociebi;
§ arasrulwlovnis mSoblis an kanonieri warmomadgenlis
interesebi da molodini, mis SegrZnebebi da emociebi;
29
§ eqimis mier gansazRvruli saWiroebebi da Sesabamisi
gadawyvetilebebi ama Tu im samedicino Carevis Taobaze.
gaiTvaliswineT, rom xSirad is, rasac mozrdilebi
samarTlianad afaseben, rogorc adekvaturi gadawyvetilebis
amsaxvel qmedebas (samedicino Carevis saxiT), bavSvisTvis mxolod
Zaladobaa, Tu is saTanadod ar aris amisTvis momzadebuli.
zemoT moxseniebuli winaaRmdegobebis dasaZlevad
arasrulwlovans SeuqmeniT uSfoTveli da naklebad
damTrgunveli garemo, pativiscemiT moepyariT, guldasmiT da
keTilganwyobilad mousmineT mas, stimuli mieciT, dagisvaT
kiTxvebi; SeecadeT, amomwuravad upasuxoT kiTxvebze, agrZnobineT,
rom misi azri TqvenTvis mniSvnelovania. gadawyvetilebis
miRebisas, SeZlebisdagvarad, gaiTvaliswineT misi azri,
daarwmuneT is, rom angariSs uwevT mis mosazrebebs, survilebs
da molodins.
mozardTan (e.w. `TineijerTan~) urTierTobisas SeecadeT, rom
drois garkveuli monakveTi marto dahyoT masTan, mSoblis
gareSe. SesaZloa, is ufro metad gendoT da gagimxiloT misTvis
intimuri informacia. imavdroulad, am informaciis safuZvelze
gadawyvetilebis miRebisas gaiTvaliswineT mSoblebis azri. im
SemTxvevaSi, Tu mSoblis/kanonieri warmomadgenlis
gadawyvetileba safrTxes uqmnis arasrulwlovnis sicocxles
da/an janmrTelobas, wvrilad moiZieT mSoblis/kanonieri
warmomadgenlis mier arasrulwlovnisTvis daxmarebis aRmoCenaze
uaris Tqmis mizezi (mag., finansuri, aRmsareblobiTi da sxv.),
detalurad ganumarteT mSobels/kanonier warmoadgenels
daxmarebaze uaris Tqmis mosalodneli Sedegebi da isic, rom
Tqven gaqvT kanoniT moniWebuli ufleba, miuxedavad
mSoblis/kanonieri warmomadgenlis uarisa, bavSvs daxmareba
aRmouCinoT, Tu es aucilebelia bavSvis sicocxlis gadasarCenad.
zemoT miTiTebul situaciaSi, Tu aucilebelia gadaudebeli
daxmareba, imoqmedeT arasrulwlovnis interesebis Sesabamisad.
30
mSoblebis/kanonieri warmomadgenlis winaaRmdegobis
SemTxvevaSi, arasrulwlovnis sicocxlis gadasarCenad mimarTeT
samarTladamcav organoebs (sapatrulo policias).
Tu gadaudebeli daxmareba ar aris aucilebeli da dro
iTmens, mimarTeT kolegebs, Tqveni dawesebulebis eTikis
komitets, administracias, uflebadamcvel organizaciebs,
socialur samsaxurebs, sasamarTlos. sasamarTlos
gadawyvetileba Sesasruleblad savaldebuloa rogorc bavSvis
mSoblisa Tu kanonieri warmomadgenlisTvis, ise eqimisTvis.
2.2.2 braldebulebi da msjavrdebulebi
braldebulebTan da msjavrdebulebTan Tqveni profesiuli,
rogorc pirdapiri, ise arapirdapiri, urTierTobis erTaderTi
mizani unda iyos maTi janmrTelobis Sefaseba, dacva da
gaumjobeseba.
moxseniebul pirTaTvis samedicino daxmarebis gawevisas
SeecadeT, kanonmdeblobiT gansazRvrul farglebSi, maTi
fizikuri da fsiqikuri janmrTelobis dacva, Rirsebisa da
avtonomiis pativiscema uzrunvelyoT imave xarisxiTa da wesebiT,
rogorc im adamianebisa, romlebic ar arian braldebulebi an
msjavrdebulebi.
arasodes gamoiyenoT Tqveni codna da unar–Cvevebi iseTi
qmedebebisaTvis, ramac SeiZleba uaryofiTad imoqmedos
braldebulisa da msjavrdebulis janmrTelobaze, Seuqmnas mas
nebismieri saxis diskomforti. amasTan, gadawyvetilebis miRebisas,
angariSi gauwieT sxvaTa, braldebulebisa Tu msjavrdebulebis,
agreTve, momsaxure personalis usafrTxoebas.
2.2.2.1 moSimSile braldebuli da msjavrdebuli
SimSilobis gamocxadeba braldebulis da msjavrdebulis
uflebaa.
wvrilad ganumarteT pirs sakvebis miRebis Sewyvetis
mosalodneli Sedegebi, darwmundiT, rom mas Seswevs
31
gacnobierebuli gadawyvetilebis miRebis, SimSilobis Sedegebis
adekvaturi Sefasebis unari.
daskvnebs moxseniebulis Taobaze nu gamoitanT
erTpirovnulad, aucileblad mouxmeT kolegas. Tu Tqven
darwmundiT, rom pacienti adekvaturad afasebs SimSilobis
mosalodnel Sedegebs, samedicino daxmareba gauwieT mxolod
misi TanxmobiT. nu SeecdebiT mis iZulebiT xelovnur kvebas;
ganumarteT mas, rom ugono mdgomareobis dadgomis SemTxvevaSi
Tqven, miuxedavad mis mier winaswar gacxadebuli nebisa, itovebT
uflebas, gamoiyenoT yvela saSualeba, maT Soris xelovnuri
kveba, misi janmrTelobis SesanarCuneblad da/an sicocxlis
gadasarCenad. aseT SemTxvevaSi gadawyvetilebis miRebisas
ixelmZRvaneleT mxolod samedicino kriteriumebiT.
2.2.3 orsuli, mSobiare da meZuZuri deda
orsulisTvis ama Tu im samedicino Carevis Taobaze
gadawyvetilebis miRebisas gaiTvaliswineT am Carevis nayofze
zemoqmedebis SesaZlebloba.
Sesabamisad, orsuls, samedicino Carevis Sesaxeb
gadawyvetilebis miRebamde, miawodeT sruli, obieqturi da
drouli informacia ganzraxuli Carevis nayofze SesaZlo
pirdapiri an iribi mavne zemoqmedebis Sesaxeb. gadawyvetileba
orsulma unda miiRos.
hkiTxeT orsuls, xom ar surs mSobiarobis dros gverdiT
iyolios meuRle an sxva misTvis sasurveli piri. survilis
SemTxvevaSi, mieciT mas amisi SesaZlebloba.
mSobiare qalisTvis samedicino daxmareba imave pirobebiT
unda ganxorcieldes, rac aRwerilia TavSi `2.1.4 informirebuli
Tanxmoba, pacientis gadawyvetilebis pativiscema~. nayofis
janmrTelobisTvis saWiro samedicino momsaxurebis Taobaze
gadawyvetilebas mSobiare Rebulobs.
Tu saWiroa iseTi samedicino momsaxureba, romelic
aucilebelia cocxali nayofis dabadebisaTvis da, amave dros,
32
minimaluri riskis matarebelia mSobiaris janmrTelobisa da
sicocxlisaTvis, magram mSobiare uars ambobs am momsaxurebaze,
ganumarteT mas momsaxurebis arCatarebis mosalodneli Sedegebi;
xazi gausviT im garemoebas, rom aseT SemTxvevaSi kanonmdebloba
gaZlevT momsaxurebis Catarebis uflebas.
SeecadeT, rom melogine qalma gverdiT iyolios axalSobili
da sakuTari Sexedulebisamebr kvebos is, Tu amis SesaZleblobas
iZleva dedisa da bavSvis janmrTeloba.
wvrilad ganumarteT melogines, ra sargebeli moaqvs ZuZuTi
kvebas bavSvisaTvis da Tavad misTvis. SeecadeT, daarwmunoT is
ZuZuTi kvebis upiratesobaSi, garda im uiSviaTesi SemTxvevebisa,
rodesac ZuZuTi kveba SeuZlebelia an ukunaCvenebia an dedis, an
bavSvisTvis.
2.2.4 eqimi da fsiqikuri daavadebis mqone pacientebi, romlebsac SezRuduli aqvT gadawyvetilebis miRebis unari
fsiqikuri daavadebis gamo gacnobierebuli gadawyvetilebis
unaris SezRudvis mqone pacientisaTvis samedicino
momsaxurebamde Tanxmoba miiReT pacientis kanonieri
warmomadgenlisagan an, misi ararsebobis SemTxvevaSi,
naTesavisagan.
Tanxmobis miRebamde pacientis kanonier warmomadgenels an
naTesavs miawodeT TavSi `2.1.3 informaciis miwodeba~ asaxuli
informacia.
amasTan, gaxsovdeT, rom aRqmisa da gagebis unaris
gaTvaliswinebiT, aucilebelia aseTi pacientebis informireba
maTi janmrTelobis mdgomareobisa da saWiro samedicino
momsaxurebis Sesaxeb
2.2.5 pacienti ganukurnebeli daavadebis terminalur stadiaze, paliatiuri mzrunveloba, tkivilis marTva
ganukurnebeli daavadebis terminalur stadiaSi myofi
pacienti gansakuTrebul mzrunvelobasa da movlas saWiroebs.
aRniSnuli moicavs pacientis simptomebis efeqtur marTvas,
pacientisa da misi ojaxis fsiqologiur mxardaWeras.
33
pacienti informirebuli unda iyos misi daavadebis Sesaxeb,
garda iSviaTi gamonaklisebisa (ix. qveTavi `2.1.3 informaciis
miwodeba~). amasTan, fataluri diagnozis Sesaxeb informaciis
miwodebisas gaiTvaliswineT pacientis pirovnuli maxasiaTeblebi,
misi informirebulobis done (ra icis Tavisi daavadebis Sesaxeb)
da survili, miiRos an ar miiRos sruli informacia;
saWiroebisas da pacientis Tanxmobis SemTxvevaSi konsultaciaSi
CarTeT ojaxis wevrebi. informaciis miwodebis Semdeg pacients
uTxariT da agrZnobineT, rom samedicino momsaxurebis gaweva
grZeldeba da yvelafers gaakeTebT mis dasaxmareblad.
arsebobs gamocdilebaze dafuZnebuli rekomendaciebi
pacientisaTvis e.w. `cudi ambebis~ (maT Soris fataluri
diagnozis) miwodebis Sesaxeb. gaecaniT maT da SeecadeT,
Sesaferis SemTxvevebSi gamoyenoT.
ganukurnebeli daavadebis terminalur stadiaSi pacientis
simptomebis (maT Soris tkivilis) marTva, misi movla da
fsiqologiuri mxardaWera saTanado momzadebas, gamocdilebasa
da unar-Cvevebs saWiroebs. Tu aseTi gamocdileba da unar-Cvevebi
gakliaT, pacientis movlaSi CarTeT Sesabamisi dargis
specialistebi (paliatiuri mzrunvelobis profesionalebi).
SeecadeT, daavadebis terminalur stadiaze myofi pacientis
movlaSi CarToT ojaxis wevrebic. pacientis survilisamebr, xeli
SuwyveT pacientTan misi ojaxis wevrebis yofnas. daexmareT
pacientis ojaxis wevrebs fsiqologiuri barieris gadalaxvaSi,
romelic maT xels uSlis momakvdavi axloblis gverdze yofnasa
da masze zrunvaSi.
Tu daavadebis terminalur stadiaze myofi pacienti uars
acxadebs samedicino momsaxurebaze, romelic pacients ver
gankurnavs, magram garkveuli xniT gaaxangrZlivebs mis
sicocxles, darwmundiT, realurad ra surs pacients. SesTavazeT
pacients ojaxis wevrebTan erTad gasaubreba. miawodeT mas
saTanado ganmartebebi. SeafaseT, rogor imarTeba pacientis
simptomebi (tkivili, Rebineba, Sekruloba, slokini da a.S.), radgan
34
mkurnalobaze uaris safuZveli SeiZleba simptomebis
araadekvaturi marTva iyos.
Tu pacients aqvs gadawyvetilebis miRebis unari da,
miuxedavad simptomebis adekvaturi marTvisa da Sesabamisi
ganmartebebis miwodebisa, uars acxadebs samedicino
momsaxurebaze, moerideT misi nebis winaaRmdeg samedicino
Carevas, Tundac es sicocxlis SemanarCunebeli mkurnaloba iyos.
amasTan, auxseniT pacientis ojaxis wevrebs, rom ar gaqvT
samedicino Carevis ufleba qmedunariani da gacnobierebuli
gadwyvetilebis unaris mqone pacientis nebis winaaRmdeg.
2.2.6 evTanazia, eqimis daxmarebiT suicidi
arasodes ar miiRoT monawileoba evTanaziaSi, rac
gulisxmobs pacientis Txovnis/moTxovnis safuZvelze pacientis
sikvdilis daCqarebas raime manipulaciis ganxorcielebis gziT.
arasodes ar daexmaroT pacients Tavis mokvlaSi (mag., ar
misceT wamali da ar aswavloT misi gamoyeneba Tavis mokvlis
mizniT).
zemoaRniSnuli qmedebebi araeTikuria, kanoniT ikrZaleba da
isjeba sisxlis samarTlis kanonmdeblobiT.
2.3. gadaudebeli samedicino momsaxureba
Tqvens samuSao adgilze pacientisaTvis gadaudebeli
samedicino momsaxurebisas ganaxorcieleT yvela saWiro Careva
Tqveni SesaZleblobis farglebSi.
arasamuSao adgilze, roca pacienti saWiroebs gadaudebel
daxmarebas, SeecadeT, SesaZleblobis farglebSi, gauwioT mas
samedicino daxmareba, Tuki iq ar imyofeba Sesabamisi profesiuli
kompetenciis eqimi an aseTi eqimi daxmarebis survils ar iCens.
kanonmdebloba avaldebulebs eqims daxmarebas arasamuSao
adgilze im SemTxvevebSi, roca Careva gadaudeblad aris saWiro.
pacientis janmrTelobasTan da Tqvens mier gaweul
samedicino daxmarebasTan dakavSirebuli informacia miawodeT
eqims, romelic gaagrZelebs pacientisaTvis samedicino
35
momsaxurebis gawevas (mag., saswrafo daxmrebis da/an saavadmyofos
gadaudebeli daxmarebis ganyofilebis eqimi).
arasamuSao adgilze gadaudebeli daxmarebis gawevisas
dauSvebelia raime sazRauris moTxovna.
iseTi garemoebebis arsebobisas, roca pacientisaTvis
gadaudebeli samedicino daxmarebis gaweva safrTxes uqmnis
Tqvens sicocxles, ixelmZRvaneleT rekomendaciebiT, romlebic
asaxulia TavSi `2.1.13.3 eqimis usafrTxoebasTan dakavSirebuli
uari~.
2.4. adamianis organoebisa da qsovilebis gadanergva
gaxsovdeT, rom donoris mier organos gacemaze
gadawyvetileba (Tanxmoba an uari) Tavisufali da nebayoflobiTi
unda iyos. es niSnavs, rom donori gadawyvetilebis miRebisas
Tavisufalia yovelgvari zewolisagan. Tu adamiani Tanaxmaa
gasces organo sxvisTvis gadasanergad garkveuli sargebelis
miRebis pirobiT (materialuri daintereseba, gaWirvebiT
ganpirobebuli finansuri imperativi) an raime sxva garemoebis
gamo (fsiqologiuri zewola, samsaxurebrivi interesebi,
msjavrdebulisaTvis sasjelis Semsubuqebis dapireba da a.S.),
aseTi gadawyvetileba ar SeiZleba CaiTvalos Tavisuflad, xolo
Tanxmoba nebayoflobiTad. amrigad, `nebayoflobiTi Tanxmoba~
~Tavisufali Tanxmobis~ sinonimia. zewolis pirobebSi miRebuli
`Tanxmoba~ ukanonoa.
adamianis organoebis gadanergvis procesSi monawileobisas,
Tu gaqvT eWvi, rom organos gacemis Taobaze donoris
gadawyvetileba ar aris misi Tavisufali nebis gamomxatveli, ar
miiRoT monawileoba transplantaciis procesSi.
adamianis organoebiT vaWroba isjeba kanoniT.
2.5. tvinis sikvdili
Tavis tvinis sikvdilis kriteriumebi da diagnozis
gaformebis procedura kanonmdeblobiT aris gansazRvruli.
36
zustad daicaviT dadgenili samarTlebrivi normebi. nebismierma
uzustobam fataluri Sedegi SeiZleba ganapirobos.
2.6. eqimis moqmedeba resursebis ukmarisobisas
resursebis ukmarisobis SemTxvevaSi:
a) miawodeT pacients sruli informacia:
§ ra saxis momsaxureba sWirdeba mas da ris gamoa SeuZlebeli
optimaluri momsaxurebis gaweva;
§ ra saxis momsaxurebis gawevaa SesaZlebeli Tqvens
dawesebulebaSi da TqvenTvis cnobil sxva dawesebulebebSi;
§ pacientisaTvis saWiro momsaxurebis dafinansebis ra
SesaZleblobebi arsebobs rogorc saxelmwifo, ise kerZo an
arasamTavrobo seqtorSi;
§ sad SeuZlia pacients miiRos misTvis saWiro damatebiTi
informacia zemoT moxseniebuli sakiTxebis Sesaxeb;
b) maqsimalurad gamoiyeneT Tqvens xelT arsebuli informacia
da resursebi pacientis sakeTildReod;
g) agreTve, ixelmZRvaneleT rekomendaciebiT, romlebic asaxulia
TavSi `2.9.2 momsaxurebis xelmisawvdomobisaTvis zrunva~.
2.7. eqimi da pacientis axloblebi, ojaxis wevrebi
daamyareT kargi urTierToba pacientis ojaxis wevrebTan da
axloblebTan. iyaviT maT mimarT gulisxmieri, gamoavlineT
Tanadgoma, daarwmuneT, rom TanaugrZnobT.
Tu qmedunarianma pacientma mogcaT ufleba, gamonaxeT dro
pacientis ojaxis wevrebTan/axloblebTan sasaubrod pacientis
daavadebis, mkurnalobisa da prognozis Sesaxeb. xazi gausviT maT
rols, mniSvnelobas pacientis movlasa da mkurnalobaSi,
SeZlebisdagvarad CarTeT isini, Tanamonawiled gaixadeT
pacientis movla-patronobaSi, mis moralur-fsiqologiur
mxardaWeraSi. daarwmuneT ojaxis wevrebi da axloblebi, rom,
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pacientis garda, Tqvenc gWirdebaT maTi daxmareba, Tanadgoma.
SeecadeT, moipovoT maTi keTilganwyoba.
Tu Tqven, qmedunariani pacientis Tanxmobis SemTxvevaSi,
miawodeT zemoT moxseniebuli informacia pacientis ojaxis
wevrs/axlobels, aucileblad detalurad asaxeT es samedicino
dokumentaciaSi. igive gaakeTeT im SemTxvevebSi, roca pacienti
qmeduunaroa.
kargad gaerkvieT, ras moelian pacientis ojaxis wevrebi
Tqvengan; SeecadeT, rom molodini realisturi iyos da
iTvaliswinebdes yvela sirTules, agreTve moulodnelobebs,
rac samedicino momsaxurebas axlavs. iyaviT gulwrfeli,
nurasodes daumalavT simarTles, raoden mwarec unda iyos igi
(cxadia, amisaTvis aucilebelia qmedunariani da gacnobierebuli
gadawyvetilebis unaris mqone pacientis Tanxmoba). gaxsovdeT
isic, rom maTi keTilganwyoba Tqvens mimarT, SesaZloa,
gagrZeldes mxolod manam, sanam samedicino momsaxureba
Sedegiania an, rogorc minimum, pacientis mdgomareobis gauareseba
ar aRiniSneba. sakuTari molodinis gaumarTleblobisas,
obieqturi faqtorebiT (daavadebis sirTule, inkurabeluroba,
dagvianebuli SemTxveva da a.S.) ganpirobebuli warumatebeli
samedicino momsaxurebisas, miT umetes, pacientis mdgomareobis
damZimebis an misi gardacvalebisas, maTi keTilganwyoba advilad
SeiZleba Seicvalos negatiuri damokidebulebiT,
agresiulobiTac ki, ganurCevlad imisa, riTi iyo zemoxsenebuli
gamowveuli – eqimis nakliT Tu sxva obieqturi garemoebebiT.
2.7.1 pacientis ojaxis wevrebi samedicino dawesebulebaSi
samedicino dawesebulebaSi (saavadmyofo, ambulatoriuli
klinika) pacientisaTvis samedicino momsaxurebis gawevisas
xSirad pacientis survilia, rom mis gverdiT imyofebodes misi
ojaxis wevri (wevrebi) an sxva pirebi, romlebTanac pacients
axlo urTierToba aqvs. zogjer, roca pacients ar aqvs survilis
gamoxatvis SesaZlebloba/unari (mcirewlovani bavSvi, fsiqikuri
daavadebis mqone piri, ugono mdgomareobaSi myofi pacienti),
38
pacientis gverdiT yofnis survils misi ojaxis wevrebi an
axloblebi gamoxataven.
arsebobs mtkicebulebebi, rom:
a) ojaxis wevrebis gverdiT yofna exmareba pacients, is Tavs
ufro komfortulad grZnobs;
b) axloblebis gverdiT yofnis Sedegad mcirdeba ojaxis
wevrebis eWvebi samedicino momsaxurebis xarisxis Sesaxeb,
mcirdeba ojaxis wevrebis wuxili da SiSi imis Taobaze, Tu
ra mdgomareobaSia maTi axlobeli; amasTan, pacientis
ojaxis wevrebs ukmayofildebaT pacientTan axlos yofnis
da misi daxmarebis survili; pacientis gardacvalebis
SemTxvevaSi, ojaxis wevrebs SedarebiT umsubuqdebaT
stresuli mdgomareoba da gloviT gamowveuli wuxili;
g) ojaxis wevrebis pacientis gverdiT yofna ar uSlis xels
samedicino momsaxurebas, ar auaresebs gamosavlebs da
uaryofiTad ar moqmedebs ojaxis wevrebis fsiqologiur
mdgomareobaze.
SeecadeT, xeli SeuwyoT pacientis axloblebis pacientis
gverdiT yofnas, iSviaTi gamonaklisebis garda, roca pacientis
ojaxis wevrebis daswrebam SeiZleba xeli SeuSalos
pacientisaTvis adekvaturi samedicino daxmarebis gawevas an
diskomforti Seuqmnas sxva pacientebs.
iTanamSromleT dawesebulebis sxva personalTan da
administraciis warmomadgenlebTan dawesebulebaSi pacientis
axloblebis yofnis Taobaze mkafio wesebis SesamuSaveblad.
miawodeT informacia am wesebis Sesaxeb pacientebis ojaxis
wevrebs da axloblebs.
2.7.2 urTierToba ojaxis wevrebTan pacientis sikvdilis SemTxvevaSi
pacientis sikvdilis Semdeg gamoiCineT yuradReba misi
axloblebis mimarT. ojaxis wevrebs, romelnic pacientis
sikvdilis mowmeni gaxdnen, uxSiresad Tavad sWirdebaT daxmareba.
uTanagrZneT maT, SeZlebisdagvarad wvrilad ganumarteT
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sikvdilis mizezebi. daarwmuneT isini Tqvens gulwrfel wuxilSi.
gaxsovdeT, rom zogjer axloblis sikvdiliT gamowveuli Sokis
Semdeg `damnaSavis” Zieba iwyeba. xSirad ojaxis wevrebi,
miuxedavad imisa, rom sikvdilis Tavidan acileba SeuZlebeli
iyo, sakuTar Tavs da/an jandacvis profesionalebs Tu mTlianad
sistemas adanaSauleben. auxseniT rom am SemTxvevaSi `damnaSave~
aravin aris, rom sikvdilis Tavidan acileba SeuZlebeli iyo.
arsebobs gamocdilebaze dafuZnebuli rekomendaciebi
gardacvlili pacientis ojaxis wevrebTan da axloblebTan
urTierTobis Sesaxeb, gaecaniT maT da SeecadeT, gamoyenoT
Sesaferis SemTxvevebSi.
2.8. eqimi da kolegebi
saeqimo saqmianobis prestiJis dacvis upirvelesi winapiroba
pacientis interesebis ganuxrelad dacvaa. amasTan erTad,
kolegebs Soris urTierTpativiscemis atmosferos damkvidreba
didad uwyobs xels saeqimo saqmianobis prestiJis amaRlebas.
2.8.1 kolegis pacienti
Tu Tqven mogmarTaT pacientma, romelsac manamde sxva eqimi
meTvalyureobda imave problemis gamo, nu daiSurebT Zalixmevas
imisaTvis, rom Tavad pacientma an misma axlobelma saqmis kursSi
Caayenon moxseniebuli eqimi momxdaris Sesaxeb. aseT SemTxvevaSi,
Tu saWirod CaTvliT diagnozis, mkurnalobis an samedicino
Carevis Taobaze adre sxva eqimis mier miRebuli gadawyvetilebis
Secvlas, SeecadeT, rom pacients es informacia ise miawodoT,
rom mas ar gauCndes ukmayofileba im eqimis mimarT, romelic mas
manamde meTvalyureobda. Tu Tqvens mier ganzraxuli cvlileba
diagnostikasa Tu mkurnalobaSi arsebiTia, SeecadeT, pacientis
TanxmobiT, Tavad daukavSirdeT moxseniebul eqims da mouTxroT
Tqveni gadawyvetilebis Sesaxeb; SeZlebisdagvarad, masTan erTad
SeecadoT rogorc Zveli, ise axali gadawyvetilebebis gansjas.
zemoxsenebuli aucilebelia im SemTxvevaSi, Tu eqimebi erT
samedicino dawesebulebaSi muSaoben, sasurvelia – Tu
sxvadasxva dawesebulebebSi arian dasaqmebuli.
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nurasodes etyviT pacients uars samedicino momsaxurebaze
imis gamo, rom manamde mas sxva eqimi mkurnalobda.
nurasodes SeecdebiT kolegis pacientis `gadabirebas”.
sakuTari Tavis qeba iseve miuRebelia, rogorc sxva eqimze augis
Tqma.
Tu Tqvens dawesebulebaSi momuSave kolega, raime mizezis
gamo, ver axerxebs pacientis samedicino momsaxurebas, yvela Rone
ixmareT, rom pacientis interesebs ziani ar miadges; SeenacvleT
kolegas Tqven Tavad an saqmis kursSi CaayeneT sxva kolegebi, ise,
rom uzrunvelyoT pacientisaTvis saWiro samedicino
momsaxurebis uwyvetoba.
2.8.2 konsiliumi
nu daaswrebT konsiliumze pacients, pacientis axlobels an
kanonier wamomadgenels. winaswar SeuTanxmeT pacients, vis unda
miewodos informacia konsiliumis gadawyvetilebis Sesaxeb –
Tavad mas, Tu mis axlobels an kanonier wamomadgenels.
gadawyvetilebis Sesaxeb informaciis mimwodeblad gamohyaviT
erT-erTi kolega konsiliumis monawileTagan.
Tu konsiliumis mimdinareobisas azrTa sxvadasxvaoba
aRiniSna, SeecadeT konsensusis miRwevas an gansazRvreT,
damatebiT ra unda gakeTdes imisaTvis, rom erTiani azri
Camoyalibdes.
konsiliumis damTavrebis Semdeg pacients (an mis axlobels,
kanonier warmomadgenels) piruTvnelad miawodeT informacia
azrTa sxvadasxvaobis Sesaxeb, wvrilad ganumarteT is obieqturi
garemoebebi, ramac drois mocemul monakveTSi SeuZlebeli gaxada
saboloo azris Camoyalibeba. ganumarteT, ra gzebi daisaxa
erTiani gadawyvetilebis misaRebad. mdgomareobis marTvis
ramdenime SesaZlo gzis arsebobisas pacients an mis axlobels
(kanonier warmomadgenels) informacia alternativebis Sesaxeb
konsiliumSi monawileTa saerTo mosazrebis saxiT miawodeT.
agreTve, acnobeT konsiliumis monawileTa erTiani rekomendacia
am alternativebis Taobaze. aseT SemTxvevaSi saboloo
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gadawyvetilebas pacienti iRebs. erideT konkretuli
mosazrebebis avtorebis dasaxelebas, Tu amas kategoriulad ar
moiTxovs pacienti an romelime mosazrebis avtori.
konsiliumis oqmSი srulad asaxeT gansxvavebuli
mosazrebebic da isic, razec konsiliumis monawileebi
SeTanxmdnen.
2.8.3 kolegis mowveva
kargad gaicnobiereT Tqveni SesaZleblobebis/kompetenciebis
farglebi sakuTar specialobaSi. nurasodes mogeridebaT imisi
aRiareba, rom specialobis garkveuli sferoebSi Tqven
srulyofili codna da/an unar-Cvevebi ar gaqvT. aseT SemTxvevebSi
moiwvieT kolega, romelic ukeT daexmareba pacients. amasTan,
ecadeT Tqveni profesiuli naklis Sevsebas uwyveti profesiuli
ganviTarebis sistemaSi monawileobis gziT.
2.8.4 kolegis saqmianobis Sefaseba
kolegis saqmianobis sityvierad an werilobiT Sefasebisas
iyaviT keTilsindisieri da obieqturi. sxvisi saeqimo saqmianobis,
gansakuTrebiT saeqimo Secdomis, Sefasebisas Tqvens mier
gamoTqmuli mosazrebebi mxolod faqtebs unda eyrdnobodes da
araviTar SemTxvevaSi hipoTezebs, daSvebebs.
yovelTvis gaiTvaliswineT da angariSi gauwieT garemos,
romelSic eqims gadawyvetilebis miReba mouxda; saxeldobr,
gansajeT, mxedvelobaSi miiReT is obieqturi faqtorebi, romelTa
arsebobac maRali albaTobiT ganapirobebs saeqimo Secdomas.
kolegis naklze Tu Secdomaze saubari dasaSvebia mxolod
profesionalTa wreSi. gansjis mizani unda iyos kolegis
profesiuli donis amaRlebis stimulireba, mis mier gaweuli
samedicino momsaxurebis xarisxis gaumjobeseba. nebismier sxva
garemoSi kolegis saqmianobis augad moxsenieba arRvevs kolegebs
Soris urTierTpativiscemis atmosferos, cudad moqmedebs saeqimo
saqmianobis prestiJze sazogadoebaSi.
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dauSvebelia konkretuli kolegis Secdomebis gansja
masobrivi informaciis saSualebebiT.
2.8.5 zrunva kolegis profesiul kompetenciaze
Tu Tqven amCnevT nakls kolegis codnaSi, mis profesiul
unar-CvevebSi, konfidencialurad da piruTvnelad miuTiTeT mas
amis Sesaxeb; Tqveni SesaZleblobis farglebSi, daexmareT naklis
gamosworebaSi.
2.8.6 kolegis janmrTelobaze zrunva
Tu kolegam mogmarTaT sakuTari janmrTelobis mdgomareobis
gamo, SeecadeT, maqsimalurad SeumsubuqoT mas saWiro
momsaxurebis miRebasTan dakavSirebuli finansuri da
organizaciuli problemebi.
2.9. eqimi da sazogadoeba
2.9.1 mosaxleobaSi cxovrebis jansaRi wesis damkvidrebisaTvis xelSewyoba
Zalismevas nu daiSurebT Tqvens pacientebs Soris, agreTve,
zogadad mosaxleobaSi, cxovrebis jansaRi wesis
damkvidrebisaTvis, prevenciuli RonisZiebebis
ganxorcielebisaTvis, mosaxleobis ganaTlebisaTvis
janmrTelobasTan dakavSirebul sakiTxebSi.
amave dros, Tqven Tavad unda iZleodeT cxovrebis jansaRi
wesis magaliTs. upirveles yovlisa es exeba iseT mavne Cvevebs,
rogoricaa Tambaqos weva, alkoholis Warbi moxmareba da misT.
2.9.2 momsaxurebis xelmisawvdomobisaTvis zrunva
Tqveni SesaZleblobebis farglebSi izruneT imisaTvis, rom:
§ gadamxdeli (saxelmwifo, sadazRvevo kompania) adekvaturad
faravdes momsaxurebas;
§ gadamxdelis (saxelmwifo, sadazRvevo kompania) mier
pacientisaTvis SeTavazebuli momsaxurebebis nusxa
SeZlebisdagvarad sruli iyos.
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2.9.3 eqimis profesiisadmi ndobis damkvidreba
saeqimo profesiisadmi ndobis damkvidrebis upirvelesi
winapirobaa Tavad eqimis saqmianobis Sesabamisoba qveyanaSi
aRiarebul profesiul da eTikur standartebTan. es gulisxmobs:
§ pacientis interesebis uzenaesobis aRiarebas;
§ sakuTari da kolegebis profesiuli SesaZleblobebis
sworad Sefasebas;
§ codnisa da unar-Cvevebis ganuwyvetel srulyofas;
§ kolegebTan erToblivi saqmianobiT momsaxurebis SesaZlo
saukeTeso xarisxis uzrunvelyofas.
SeecadeT, xeli SeuwyoT mosaxleobaSi medicinis
SesaZleblobebze realuri warmodgenebis Camoyalibebas; nu
SeecdebiT, nu SeuwyobT xels sazogadoebaSi iseTi molodinis
damkvidrebas, romlis ganxorcielebac SeuZlebelia. es exeba
rogorc teqnologiur (sadiagnozo, samkurnalo Tu sxv.)
siaxleebs, ise mTlianad jandacvis sistemis SesaZleblobebs.
sistemis prioritetebis sazogadoebis TanamonawileobiT
gansazRvra, maTi saTanadod dasabuTeba xels uwyobs
sazogadoebaSi jandacvis sistemisadmi, eqimis profesiisadmi
ndobis damkvidrebas.
2.10. eqimi da masobrivi informaciis saSualebebi
masobrivi informaciis saSualebebTan TanamSromloba eqims
saSualebas aZlevs sazogadoebis yuradReba gaamaxvilos
mosaxleobis janmrTelobisa da misi dacvis mniSvnelovan
aspeqtebze, maT Soris:
§ cxovrebis jansaR wessa da daavadebaTa prevenciaze;
§ janmrTelobis sxvadasxva problemis marTvaSi pacientis
rolze;
§ samedicino momsaxurebis xelmisawvdomobis problemaze.
SeecadeT iTanamSromloT masobrivi informaciis
saSualebebTan zemoxsenebul sakiTxebze.
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amasTan, ar gamoiyenoT masobrivi informaciis saSualebebi
sakuTari upiratesobis warmoCenisaTvis sxva eqimebisa Tu
samedicino dawesebulebebis saqmianobasTan Sedarebis gziT.
masobrivi informaciis saSualebebisaTvis informaciis
miwodebisas ar daasaxeloT konkretuli pacientis vinaoba, ar
gaTqvaT pacientebis Sesaxeb TqvenTvis cnobili konfidencialuri
informacia, Tuki amis Sesaxeb winaswar ar gaqvT miRebuli
pacientis da/an misi kanonieri warmomadgenelis Tanxmoba (ix. Tavi
`2.1.5 informaciis konfidencialuroba~).
ar dauSvaT pacientebis video- da fotogadaReba, Tu miRebuli
ar gaqvT pacientis da/an misi kanonieri warmomadgenlis Tanxmoba.
2.11. eqimi da TviTmkurnaloba, eqimis mier sakuTari ojaxis
wevrebis mkurnaloba
nu umkurnalebT sakuTar Tavs, Tqveni ojaxis wevrebs, Zalian
axloblebs. gaxsovdeT, rom aseT SemTxvevebSi maRalia imisi
albaToba, rom Tqvens mier miRebuli gadawyvetileba obieqturi,
xolo gaweuli daxmarebis xarisxi adekvaturi ar iqneba.
am wesidan gamonaklisi dasaSvebia mxolod im SemTxvevaSi, Tu
samedicino momsaxurebis gaweva gadaudeblad aris saWiro da/an
sxva eqimis moZieba SeuZlebelia.
2.12. eqimi da industria
winamdebare dokumentSi termini `industria” gulisxmobs
samewarmeo (komerciul, mogebaze orientirebul) iuridiul pirs,
romlis nawarmi/produqti gamoiyeneba jandacvis sferoSi.
aseTebia:
§ farmacevtuli industria;
§ bioteqnologiuri industria;
§ bavSvTa xelovnuri sakvebis mwarmoebeli industria;
§ parenteraluri kvebis produqtebis mwarmoebeli industria;
§ samedicino xelsawyoebis mwarmoebeli industria.
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janmrTelobis dacvis sferos TanamSromloba industriasTan
sasargebloa pacientisTvis, eqimisTvis da mTlianad
sazogadoebisaTvis. imavdroulad, industriis miznebi, zogjer, ar
eTanadeba jandacvis sistemis prioritetebs, xolo eqimebis
`gulis monadirebis” meTodebi, zogjer, scildeba samedicino
eTikis farglebs.
industriasTan urTierTobisas yvela SemTxvevaSi guldasmiT
gansazRvreT, gaweuli daxmarebis sanacvlod (sponsorobisaTvis)
ras iTxovs Tqvengan industriis warmomadgeneli. mxolod amis
Semdeg miiReT gadawyvetileba daxmarebis gamoyenebis Sesaxeb.
samedicino dawesebulebaSi, sasurvelia, industriasTan
urTierTobisTvis gamoiyos piri, romelic pasuxismgebeli iqneba
am urTierTobis adekvaturobis uzrunvelyofaze. es funqcia
SeiZleba ikisros eTikis komitetma, romelic SeimuSavebs
saTanado rekomendaciebs. es rekomendaciebi da maTi
Camoyalibebis safuZveli cnobili unda iyos dawesebulebis
personalisaTvis.
kerZo/individualuri praqtikis SemTxvevaSi industriasTan
urTierTobisas gaiTvaliswineT Semdegi rekomendaciebi:
§ industriis mier warmoebuli produqtis gavrcelebisaTvis
xelSewyobis pirobiT ar miiRoT industriis
warmomadgenlebisagan sazRauri an saCuqari, maT Soris, raime
produqti (wamali, samedicino xelsawyo, xelovnuri sakvebi
da sxv.) an sponsoroba (nebismieri formiT);
§ dauSvebelia industriis ama Tu im produqtis (wamali,
samedicino xelsawyo, xelovnuri sakvebi da sxv.) sareklamo
furclebis, gancxadebebis gavrcelebaSi eqimis monawileoba;
§ pacientisTvis wamlis SerCevisas, receptis gamowerisas
ixelmZRvaneleT mxolod pacientis interesebiT; nurasodes
gamowerT wamals farmacevtuli kompaniis logoTi moniSnul
receptis blankze;
46
§ guldasmiT gansajeT industriis winadadeba sponsoroba
gauwios samecniero konferenciebze, sxvadasxva Sexvedrebze
Tqvens daswrebas, saganmanaTleblo RonisZiebebSi
monawileobas (mgzavrobis, sastumros xarjebi,
monawileobisaTvis Sesatani Tanxis anazRaureba da sxv.);
§ kompensaciis miReba momsaxurebisTvis, romelic gaewia
industrias, gamWvirvale unda iyos; mis Sesaxeb acnobeT
damqiravebels da, saWiroebis SemTxvevaSi, pacients;
§ Tu Tqven dakavSirebuli xarT farmacevtul kompaniasTan da
monawileobT klinikuri praqtikis erovnuli rekomendaciis
(gaidlainis) momzadebaSi, aucileblad acnobebT amis Sesaxeb
kolegebs, romlebTan erTadac amzadebT zemoxsenebuls.
2.13. eqimi da dazRvevis sistema
kargad gaerkvieT janmrTelobis dacvis arsebul sistemaSi,
sadazRvevo pirobebSi. miawodeT pacients sruli informacia imis
Taobaze, ra momsaxurebis miReba SeuZlia mas sadazRvevo
polisiT, ra gamonaklisebia daSvebuli sadazRvevo
xelSekrulebiT.
yovelTvis ecadeT, racionalurad gamoiyenoT samedicino
momsaxurebisaTvis sadazRvevo kompaniebis mier gamoyofili Tanxa.
amasTan, SeecadeT, ar misceT saSualeba dazRvevis sistemas
imoqmedos medicinaSi arsebuli profesiuli da eTikuri
standartebis, pacientis janmrTelobis interesebis sazianod.
2.14. saCuqari eqims uangaroba da samarTlianoba eqimis pacientis mimarT
ganwyobis ZiriTadi ganmsazRvrelia. profesiuli saqmianobisas
sargeblis miRebis principiT nurasodes imoqmedebT.
eqimisTvis saCuqris mirTmeva medicinis Tanamdevi tradiciaa. erT
SemTxvevaSi saCuqari gulwrfeli madlierebis gamoxatulebaa
(sikeTiT sikeTis gadaxda), meore SemTxvevaSi qvelmoqmedebaa, sxva
SemTxvevaSi mas eqimze gavlenis moxdenis (raRac privilegiebis
mopovebis) survili udevs safuZvlad. eqims SeiZleba gauWirdes
47
garkveva – ra motiviT xelmZRvanelobs pacienti – altruizmiT da
gulwrfeli madlierebis grZnobiT, Tu pragmatuli mosazrebebiT.
es gairkveva xolme pacientsa da eqims Soris urTierTobis
Semdgom etapebze. mTavaria, rom saCuqarma ar imoqmedos Tqvens
ganwyobaze pacientis mimarT, misTvis gaweuli samedicino
momsaxurebis xarisxze. amasTan, gaxsovdeT, rom Tu pacientis mier
TqvenTvis saCuqris morTmevis mizania samedicino momsaxurebisas
raRac upiratesobebis miRebaa, saCuqris miReba dauSvebelia.
2.15. eqimis saqmianobis TviTreklama
nu SeecdebiT, sityvierad Tu werilobiT, Tqvens
upiratesobaze saubars kolegebisa da sxva samedicino
dawesebulebebis saqmianobis dakninebis xarjze.
amasTan, SegiZliaT, sazogadoebas sxvadasxva formiT
miawodoT mkafio informacia Tqvens mier SeTavazebuli
samedicino daxmarebis Sesaxeb. es ukanaskneli SeiZleba Seicavdes
momsaxurebis saxeebis detalur CamonaTvals, gamoyenebul
meTodebs, agreTve, Tqveni kvalifikaciis amsaxvel masalas
(saxelmwifo sertifikatis flobas ama Tu im specialobasa Tu
subspecialobaSi, gamocdilebis damadasturebel faqtebs).
2.16. eqimis urTierToba damqiravebelTan, SromiTi xelSekruleba
yuradRebiT gaecaniT damqiravebelTan SromiT xelSekrulebas.
xelSekruleba unda asaxavdes mxareTa valdebulebebs,
daqiravebulis mier Sesasrulebuli samuSaos aRwerilobas,
saxelSekrulebo vadas vadis dasawyisisa da dasasrulis
CvenebiT. miaqcieT yuradReba, rom xelSekrulebaSi asaxuli iyos
adekvaturi Sromis anazRaureba, samuSao garemos adekvaturobis
aucilebloba. xelSekrulebaSi SeiZleba Sevides damatebiTi
pirobebic, kanonmdeblobiT gaTvaliswinebulisagan gansxvavebuli,
magram damatebiTma pirobebma ar SeiZleba SezRudos an
gaauaresos kanoniT dadgenili moTxovnebi. saxeldobr, Tu
SromiTi xelSekrulebis pirobebi, Sromis kodeqsSi asaxul
normebTan SedarebiT, auareseben daqiravebulis mdgomareobas,
aseTi normebi baTilia.
48
damqiravebeli valdebulia Seasrulos rogorc
kanonmdeblobiT gansazRvruli pirobebi, aseve is piroba,
romelic damatebiT Sevida xelSekrulebaSi. amave dros,
damqiravebels ufleba aqvs muSakisaTvis sakuTari saxsrebis
xarjze daadginos kanonmdeblobasTan SedarebiT damatebiTi
SromiTi da socialuri SeRavaTebi.
2.17. samedicino momsaxurebis xarisxi da pacientis usafrTxoeba
samedicino momsaxurebis xarisxi da pacientis usafrTxoeba
eqimis upirvelesi sazrunavia. xsenebulis uzrunvelyofisaTvis
gamudmebiT izruneT sakuTari codnisa da unar-Cvevebis
srulyofisaTvis. amave dros, gaiTvaliswineT, rom momsaxurebis
xarisxi da usafrTxoeba ar aris damokidebuli mxolod Tqvens
codnaze, gamocdilebasa da unar-Cvevebze. samedicino
momsaxurebis gamosavals da pacientis kmayofilebas mravali
faqtori ganapirobebs, saxeldobr: sxva samedicino personalis
profesiuli done, anazRaurebis adekvaturoba, samuSao garemo,
dawesebulebis Sinaganawesi, aRWurviloba, samedicino
momsaxurebis danergili standartebi, dawesebulebaSi
momsaxurebis xarisxisa da pacientTa usafrTxoebis
uzrunvelyofis formalizebuli sistemis arseboba, samedicino
personalsa da dawesebulebis xelmZRvanelobas Soris
urTierTobis Taviseburebebi, saeqimo saqmianobis qveyanaSi
arsebuli maregulirebeli garemo da sxv.
2.17.1 samedicino momsaxurebis xarisxisa da pacientTa usafrTxoebis uzrunvelyofaSi monawileoba
nu daiSurebT Zalisxmevas Tqvens dawesebulebaSi
momsaxurebis xarisxisa da pacientTa usafrTxoebis
uzrunvelyofis sistemis CamoyalibebisTvis. aqtiuri monawileoba
miiReT am sistemis funqcionirebaSi, SeZlebisdagvarad, xeli
SeuwyveT kolegebs masSi CarTvisaTvis. zemoxsenebuli
gulisxmobs:
§ dawesebulebis Sida konsiliumebis organizebas da maTSi
monawileobas;
49
§ klinikur-paTologiuri konferenciebis Catarebas da maTSi
monawileobas;
§ klinikuri praqtikis gaidlainebisa da protokolebis
adaptaciasa da danergvaSi monawileobas, maT gamoyenebas
yoveldRiur saqmianobaSi;
§ Sida da gare auditis sistemis danergvas da masSi
monawileobas;
§ uwyveti profesiuli ganviTarebis sistemaSi monawileobas;
§ kolegebis saqmianobis konstruqciul, keTilganwyobil
kritikas, maT mier gamoTqmul SeniSvnebze Tqvens
konstuqciul reaqcias;
§ gardacvlili pacientebis samedicino dokumentaciis
ganxilvaSi monawileobas;
§ jandacvis sistemis, saeqimo saqmianobis maregulirebeli
aqtebis SemuSavebasa da ganxilvaSi monawileobas; ukve
arsebul maregulirebel aqtebSi naklis gamovlenisas maTi
srulyofis mcdelobas saxelisuflo organoebis,
profesiuli asociaciebis, pacientTa organizaciebis
CarTviT.
2.17.2 samuSao garemo
adekvaturi samuSao garemo da adekvaturi anazRaureba eqimis
kanonmdeblobiT gaTvaliswinebuli uflebebia. dawesebulebis
xelmZRvaneloba/damqiravebeli valdebulia izrunos rogorc
erTis, ise meoris srulyofaze. saWiroebis SemTxvevaSi, nu
mogeridebaT amis Taobaze maTTvis Sexseneba.
zemoT Tqmuli srulad exeba dawesebulebaSi resursebis
deficitsac, ramac SeiZleba xeli SeuSalos adekvaturi
xarisxisa da pacientisaTvis usafrTxo samedicino momsaxurebas.
werilobiT miawodeT dawesebulebis xelmZRvanels/
damsaqmebels saTanado informacia, saWiroebis SemTxvevaSi
CarTeT saxelisuflo organoebi, profesiuli asociaciebi,
pacientTa uflebebis damcavi organizaciebi. gaxsovdeT, rom
50
zemoxsenebuli garemoebebisas pacientisaTvis zianis
miyenebisaTvis pasuximgebloba, SesaZloa, Tqven dagekisroT.
2.18. samedicino dokumentaciis warmoeba
guldasmiT SeavseT pacientis samedicino dokumentacia.
aucileblad SeitaneT pacientis saidentifikacio monacemebi,
sruli informacia daavadebis diagnozis, mkurnalobis,
mimdinareobis, gamosavlis Taobaze. ama Tu im Carevis
(sadiagnozo, samkurnalo da a.S.) Sesaxeb gadawyvetilebis
amsaxvel CanawerSi detalurad, adekvaturad asaxeT
gadawyvetilebis miRebis safuZveli, agreTve, informacia,
romelic pacients (an mis kanonier warmomadgenels/axlobels)
miewoda Carevis Sesaxeb; mkafiod gadmoeciT moxseniebulTa
Tanxmoba an uari. kanoniT gansazRvrul SemTxvevebSi
aucilebelia, pacientma an , misma kanonierma warmomadgenelma
Tanxmoba xelis moweriT daadasturos (ix. Tavi `2.1.4
informirebuli Tanxmoba, pacientis gadawyvetilebis
pativiscema~).
diagnozTan Tu mkurnalobasTan dakavSirebiT raime eWvis
arsebobisas /daafiqsireT dokumentaciaSi eWvis safuZveli da is
RonisZiebebi, rac aucilebelia am eWvis gasaqarwyleblad an
dasadastureblad.
Tu Tqveni rekomendaciis Sesruleba obieqturi garemoebebis
gamo SeuZlebelia, miuTiTeT dokumentaciaSi mizezebze, SesaZlo
gavlenaze daavadebis mimdinareobasa da gamosavalze. aRwereT is
RonisZiebebi, romlebic rekomendaciis SesrulebisTvis
ganaxorcieleT. saWiroebisas, mimarTeT dawesebulebis
xelmZRvanelobas, eTikis komitets.
samedicino dokumentaciaSi asaxuli informacia
konfidencialuria, misi gamJRavneba SeiZleba mxolod kanoniT
gaTvaliswinebul SemTxvevebSi.
Tu samedicino dokumentaciaSi raime Secdomaa daSvebuli,
gaasworeT is. mcdari informaciis Secvlisas an arasruli
51
informaciis Sevsebisas nu waSliT Zvel Canawerebs. aucileblad
miuTiTeT Secdomis mizezi (mag., gvian SegatyobinaT pacientma an
misma axlobelma/kanonierma warmomadgenelma, gvian miiReT
sadiagnozo kvlevis Sedegebi da sxv.) da ise SeitaneT axali
informacia.
gaxsovdeT, rom samedicino Canawerebi SeiZleba gamoyenebuli
iqnes samedicino momsaxurebis xarisxis analizisTvis (mag.,
auditis sistema) misi gaumjobesebis mizniT, swavlebisTvis,
samecniero kvlevisTvis. gaiTvaliswineT is garemoebac, rom
samedicino Canawerebi, SesaZloa, gamoyenebuli iqnes
samarTaldamcavi organoebis, sasamarTlos mier, rogorc
mtkicebuleba. amasTan, samarTaldamcavi organoebi, bunebrivia,
xelmZRvaneloben mxolod dokumentaciaSi asaxuli faqtebiT.
amitomac, detalurad asaxeT dokumentaciaSi nebismieri garemoeba
Tu faqti dakavSirebuli Tavad pacientTan an mis
axloblebTan/ojaxis wevrebTan, maTi fsiqologiuri
maxasiaTeblebi, maT Soris urTierTobis Taviseburebebi, rac
xels uSlis adekvatur samedicino momsaxurebas; yuradReba
gaamaxvileT sxva xelSemSlel garemoebebzec (mag., ama Tu im
sadiagnozo Tu samkurnalo meTodis gamoyenebis SeuZlebloba),
ramac daabrkola samedicino momsaxurebis adekvaturad
ganxorcieleba, im RonisZiebebzec, romelsac Tqven mimarTeT am
naklis aRmosafxvrelad.
Tu pacientis janmrTelobis mdgomareobis Sesaxeb cnobas
gascemT ucxo enaze, pasuxismgebloba informaciis
adekvaturobaze Tqven gekisrebaT.
2.19. eqimis moqmedeba, roca samedicino momsaxureba
warumatebeli aRmoCndeba
samedicino momsaxurebis warumateblobis SemTxvevaSi pacients
(mis axlobels, kanonier warmomadgenels) detalurad ganumarteT
misi mizezebi. ganmartebebis micemamde gaiazreT da dagegmeT
saubris qarga, moemzadeT mosalodnel SekiTxvebze pasuxis
gasacemad, SeZlebisdagvarad, gaiTvaliswineT msmenelis
52
mosalodneli reaqcia. saubari CaatareT mSvid, komfortul
garemoSi. daarwmuneT msmeneli, rom Tqven gulwrfelad
TanaugrZnobT mas.
warumatebeli samedicino momsaxureba aucileblad unda
gaxdes TqvenTvis sakuTari profesiuli saqmianobis Sefasebis
safuZveli. eZieT sakuTari nakli, ramac, SesaZloa, ganapiroba
warumatebloba. izruneT am naklis aRmofxvraze.
2.20. eqimis moqmedeba saeqimo Secdomis daSvebisas
saeqimo profesia maRali riskis matarebeli urTulesi
profesiaa. Tqven arasodes xarT dazRveuli profesiuli
Secdomisgan. es ukanaskneli SeiZleba ganpirobebuli iqnes
Tqvengan sruliad damoukidebeli faqtorebiT –
aRWurvilobis/resursebis, medikamentebis an damxmare
saSualebebis ukmarisobiT, samuSao garemos arasrulfasovnebiT.
amave dros, Secdomis mizezi SeiZleba gaxdes Tavad Tqveni
codnis ukmarisobა an unar-Cvevebis arasaTanado done.
Tu samedicino Secdoma kolegebis wreSi ganixileba, maTTan
erTad SeecadeT, gansazRvroT Tqvens mier daSvebuli Secdomis
mizezebi da, imavdroulad, dasaxoT gzebi momavalSi msgavsi
Secdomis Tavidan asacileblad. wynarad moismineT da
gaaanalizeT kolegebis SeniSvnebi; gaxsovdeT, rom koleebis
wreSi sakuTari Secdomis gulwrfeli aRiareba da gansja
profesionalizmis maRal doneze miuTiTebs.
sxvisi Secdomis Sefasebisas yovelTvis gaiTvaliswineT, rom
saeqimo Secdoma niSnavs, rom konkretuli eqimisTvis SeuZlebeli
gaxda mocemul situaciaSi sakuTari qmedebis an umoqmedobis
Sedegebis gaTvaliswineba an Tavidan acileba. piruTvnelad,
magram keTilganwyobilad gansazRvreT Secdomis savaraudod
ganmapirobebeli garemoebebi. amasTan, garda subieqturi
faqtorebisa (eqimis codna, gamocdileba, unar-Cvevebi),
aucileblad gaaanalizeT is garemo, romelSic eqims uxdeboda
saqmianoba, SeafaseT, aseT garemoSi iyo Tu ara SesaZlebeli
swori gadawyvetilebis miReba.
53
2.21. momCivani pacienti
samedicino momsaxureba, Tundac absoluturad adekvaturi,
yovelTvis efeqturi ar aris, rac SeiZleba saCivris safuZveli
gaxdes. aseT SemTxvevaSi (roca gamoricxulia saeqimo Secdoma)
ganumarteT pacients, rom uefeqtobis mizezi medicinis
arasrulyofilebaa da ara Tqveni nakli. saCivris mizezi,
zemoxsenebulis garda, SeiZleba Tavad pacientis pirovnuli
maxasiaTeblebic iyos (ix. qveTavi 2.1.11 `rTuli pacienti”) an
momsaxurebis organizaciuli mxaris arasrulyofileba (didxans
mouxda lodini, gundis wevri – sxva specialisti, eqTani,
damlagebeli da a.S. – ar iyo koreqtuli mis mimarT) da sxva
mravali.
xSirad pacientis saCivari momsaxurebaSi arsebuli naklis
dafiqsirebis mniSvnelovani saSualebaa. amitomac yuradRebiT
mousmineT momCivan pacients, nu SeawyvetinebT saubars, acaleT
mas bolomde da srulad gamoxatos ukmayofilebis mizezi da
SeecadeT gaiTavisoT is. nu mogeridebaT mobodiSebis, es
ukanaskneli ar niSnavs Tqveni Secdomis an bralis aRiarebas; is
gagebisa da tolerantobis gamovlenis saukeTeso gzaa. Tu
ukmayofileba momsaxurebis organizaciul problemebTan aris
dakavSirebuli, madloba gadauxadeT mas imisaTvis, rom saqmis
kursSi CagayenaT, daarwmuneT, rom Tqven seriozulad aRiqvamT
mis mier danaxul nakls, dahpirdiT, rom es aRar ganmeordeba arc
mis da arc sxva pacientebis mimarT. ganumarteT, ra zomebs
miiRebT amisaTvis. amasTan, iyaviT gulwrfeli, nu dahpirdebiT
imas, rasac ver SeasrulebT.
pacientis Civilma araviTari gavlena ar unda moaxdinos
misTvis samedicino momsaxurebis xelmisawvdomobaze da/an
xarisxze.
2.22. eqimi da samarTaldamcavi organoebi, sxva saxelmwifo
dawesebulebebi
samarTaldamcavi organoebis an sxva saxelmwifo
dawesebulebebis momarTviT Catarebuli eqspertizis SemTxvevebSi
54
iyaviT obieqturi, piruTvneli. aucileblad gaiTvaliswineT
garemo, romelSic eqims uxdeboda gadawyvetilebis miReba,
pacientisa an/da misi axloblebis (kanonieri warmomadgenlis)
fsiqologiuri maxasiaTeblebi, socialuri, kulturuli
Taviseburebebi; iyo Tu ara SesaZlebeli da Tu iyo, ramdenad
sakmarisi dro hqonda eqims pacientTan (mis axlobelTan/kanonier
warmomadgenelTan) Terapiuli aliansis CamoyalibebisaTvis.
daskvnebis gakeTebisas Tqveni orientiri nu iqneba saSualo
statistikuri maCveneblebi, literaturul monacemebze
damyarebuli mosazrebebi. klinikuri praqtikis gaidlainiTa da
protokoliT gaTvaliswinebuli rekomendaciebis eqimis
qmedebebTan Sejerebisas aucileblad gaiTvaliswineT maTi
realizaciis SesaZlebloba im konkretul garemoSi da im
konkretul pacientTan. aseve, gaiTvaliswineT rekomendaciebi,
romlebic asaxulia TavSi `2.20 eqimis moqmedeba saeqimo Secdomis
daSvebisas~.
2.23. sakuTar profesiul kompetenciaze zrunva, uwyveti
profesiuli ganviTareba
adekvaturi, profesiuli da eTikuri standartebis Sesabamisi
samedicino momsaxurebisaTvis aucilebelia sakuTari codnisa da
unar-Cvevebis gamudmebiT ganaxleba da srulyofa. es procesi
Tqveni profesiuli saqmianobis dawyebisas unda iRebdes dasabams
da grZeldebodes manam, sanam Tqven dakavebuli xarT saeqimo
saqmianobiT. nurasodes irwmunebT, rom Tqveni saqmianoba
srulyofilia. mxolod sakuTari gamocdileba da dagrovebuli
codna, marTalia, mniSvnelovania, magram raRac etapze (axali
teqnologiebi, axali medikamentebi, mkurnalobis axali meTodebi
da sxv.) arasakmarisi xdeba medicinis miRwevebis Sesabamisi
samedicino momsaxurebis uzrunvelyofisaTvis.
2.24. eqimi da axali teqnologiebi
axali teqnologiebis gamoyenebisas `iCqareT nela”.
darwmundiT, rom arsebobs mtkicebulebebi maTi gamoyenebis
sargeblianobis Sesaxeb; gansajeT, ra siZneleebs Segiqmnian axali
55
teqnologiebis gamoyenebis gzaze manamde damkvidrebuli
tradiciebi da midgomebi. teqnologiis gamoyenebamde gaiareT
saTanado mzadebis kursi. uTxariT pacients, ra gamocdileba
gaqvT am teqnologiis gamoyenebaSi da mxolod amis Semdeg miiReT
misi informirebuli Tanxmoba proceduris Catarebaze.
axali wamlis gamoyenebamde moiZieT mtkicebulebebi misi
efeqturobis Sesaxeb.
darwmundiT, rom wamali registrirebulia qveyanaSi
(daSvebulia saqarTvelos bazarze) da mxolod amis Semdeg
gamouwereT pacients.
amasTan, rodesac es aucilebelia pacientis
janmrTelobisaTvis, SegiZliaT pacients urCioT nebismieri
dauregistrirebeli wamlis gamoyenebac. aseT SemTxvevebSi
acnobeT pacients, rom kanonmdeblobiT daSvebulia calkeuli
pacientis saWiroebisaTvis arakomerciuli mizniT wamlebis
Semotana `saqarTvelos bazarze daSvebis reJimis~ gverdis avliT3.
2.25. eqimi da telemedicina
telemedicinis gamoyenebiT miRebuli konsultaciis
safuZvelze pacientisaTvis rekomendaciis micemisas misi
ganxorcielebis Sedegze pasuxismgebloba Tqven gekisrebaT.
pacientis moTxovniT, monacemebi misi janmrTelobis
mdgomareobisa da piradi cxovrebis Sesaxeb SeiZleba gadaices
pacientis vinaobis dasaxelebis gareSe.
2.26. eqimi mkvlevari
biosamedicino kvleva aucilebelia medicinis
ganviTarebisaTvis da efeqturi prevenciuli, sadiagnozo,
samkurnalo Tu sareabilitacio meTodebis SemuSavebisaTvis.
xeli SeuwyveT mkvlevarebs, romlebic kvlevas gegmaven Tqvens
dawesebulebaSi da TanamSromlobas SemogTavazeben. amasTan,
yovelTvis gaiTvaliswineT kvlevis subieqtis usafrTxoebisa da
3 saqarTvelos kanoni `wamlisa da farmacevtuli saqmianobis Sesaxeb~, muxli 1113.
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uflebebis dacvis aucilebloba. pacientis usafrTxoeba da
janmrTeloba upiratesia kvlevis miznebTan SedarebiT.
kvlevaSi monawileobaze da/an kvlevaSi Tqveni pacientebis
CarTvaze Tanxmoba ganacxadeT mxolod maSin, Tu kvlevis gegma
damtkicebulia Sesabamisi eTikis komitetis mier. aRniSnulSi
dasarwmuneblad sTxoveT mTavar mkvlevars, rom warmogidginoT
eTikis komitetis daskvna.
kvlevaSi pacientebis CarTvamde:
§ guldasmiT waikiTxeT kvlevis gegma da informirebuli
Tanxmobis forma;
§ dawvrilebiT gaecaniT kvlevis miznebs, meTodebs, kvlevis
subieqtis SerCevis gzebs. gaarkvieT, ra sargebloba SeiZleba
moitanos kvlevis Sedegebma zogadad, agreTve, ra
sargebloba SeiZleba hqondes mas Tqveni pacientebisTvis an
Tqveni pacientebis mdgomareobaSi myofi sxva pirebisTvis;
gaarkvieT, ra riski axlavs kvlevas, ra diskomforts
SeiZleba ganicdides kvlevis subieqti (pacienti) kvlevaSi
monawileobisas.
Tu pacientis Tanxmobis miReba kvlevaSi monawileobaze Tqven
gevalebaT, Tqven unda:
§ gaacnoT pacients kvlevis mizani, mosalodneli sargebeli
piradad misTvis, agreTve mis mdgomareobaSi myofi sxva
pirebisaTvis; darwmundeT, rom pacients ar aqvs
gadaWarbebuli, usafuZvlo molodini kvlevaSi monawileobis
sargeblianobis Sesaxeb;
§ miawodoT informacia pacients kvlevaSi monawileobasTan
dakavSirebuli riskisa da diskomfortis Sesaxeb;
§ misceT pacients werilobiTi informirebuli Tanxmobis
forma, romelic Seicavs dawvrilebiT informacias kvlevis
Sesaxeb da misceT mas dro da saSualeba, gaecnos aRniSnul
formas;
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§ sTxovoT pacients, rom dagisvaT kiTxvebi misTvis saintereso
sakiTxebze mas Semdeg, rac igi gaecnoba informirebuli
Tanxmobis formaSi asaxul informacias. SeecadeT upasuxoT
mis kiTxvebs martivi, gasagebi eniT; darwmundiT, rom
pacientma gaigo misTvis saintereso yvela sakiTxi;
§ mkafiod acnoboT pacients, rom mas ufleba aqvs uari Tqvas
kvlevaSi CarTvaze, agreTve, nebismier etapze ganacxados
uari ukve dawyebul kvlevaSi monawileobaze da gamoeTiSos
mas;
§ aseve mkafiod acnoboT pacients, rom uari kvlevaSi
CarTvaze an ukve dawyebuli kvlevidan gamoTiSva araviTar
gavlenas ar moaxdens misTvis saWiro samedicino
momsaxurebis gawevaze;
§ misceT pacients dro gadawyvetilebis misaRebad kvlevaSi
monawileobis Taobaze;
§ daafiqsiroT informirebuli Tanxmobis formaze pacientisa
da Tqveni, rogorc mkvlevaris, xelmowera mxolod mas
Semdeg, rac darwmundebiT, rom pacientma, rogorc kvlevis
subieqtma, aRiqva yvela mniSvnelovani informacia kvlevaSi
monawileobasTan dakavSirebiT da rom misi Tanxmoba
Tavisufalia yovelgvari zegavlenisagan.
kvlevis mimdinareobisas:
§ yuradReba miaqcieT, rom gamoyenebuli kvlevis meTodebi
zedmiwevniT emTxveodes kvlevis gegmaSi asaxul
meTodologias;
§ uzrunvelyaviT pacientis Sesaxeb arsebuli monacemebis
konfidencialuroba kvlevis gegmaSi asaxuli meTodologiis
Sesabamisad.
§ SeafaseT pacientis janmrTelobis mdgomareoba kvlevaSi
monawileobasTan dakavSirebuli SesaZlo riskisa da
diskomfortis gaTvaliswinebiT. gaxsovdeT, rom, rogorc
zemoT ukve iyo aRniSnuli, pacientis usafrTxoeba da
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janmrTeloba upiratesia kvlevis miznebTan SedarebiT,
raoden mniSvnelovanic ar unda iyos es ukanaskneli.
§ kvlevis procesSi wamoWrili nebismieri gauTvaliswinebeli
garemoebebis warmoqmnisas dauyovnebliv acnobeT mTavar
mkvlevars, romelic valdebulia amis Sesaxeb acnobos
Sesabamis eTikis komitets, agreTve, kanonmdeblobiTa da
kvlevis gegmiT gaTvaliswinebul struqturebsa da pirebs.
§ daicaviT obieqturoba da miRebuli monacemebi daafiqsireT
zustad, rogoric ar unda iyos is (sasurveli Tu
arasasurveli mkvlevarTa jgufisaTvis an sponsorisTvis).
2.27. eqimi maswavlebeli
pedagogiuri saqmianoba xels uwyobs Tavad eqimis profesiul
ganviTarebas. Tu mogecaT SesaZlebloba, nurasodes ityviT uars
studentebis, rezidentebis, eqimebis ganswavlaSi da mzadebaSi
monawileobaze. saqmianobis efeqturobisaTvis kargad gaiTaviseT
mozrdilTa swavlebis meTodologia da unar-Cvevebi.
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3. saqarTvelos eqimis qcevis wesebis danergva
`saqarTvelos eqimis qcevis wesebSi” asaxuli rekomendaciebis
gamoyeneba nebayoflobiTia.
amasTan, imis gaTvaliswinebiT, rom `saqarTvelos eqimis qcevis
wesebi” efuZneba moqmed kanonmdeblobas da aRiarebul eTikur
standartebs, am wesebis gamoyeneba eqims daexmareba usafrTxo,
Tanamedrove eTikuri standartebis Sesabamisi samedicino
praqtikis warmarTvaSi. qcevis wesebis dacva saSualebas miscems
eqims, erTi mxriv, sul mcire, Tavi aaridos kanonmdeblobasTan
konfliqts, xolo meore mxriv, mudmivad aamaRlos mis mier
gaweuli samedicino momsaxurebis xarisxi da gazardos
pacientebis kmayofileba.
`saqarTvelos eqimis qcevis wesebis” danergvis ZiriTadi gzaa
am wesebis oficialuri aRiareba eqimTa dargobrivi asociaciebis
mier. wesebis aRiarebiT asociacia mouwodebs sakuTar wevrebs,
ixelmZRvanelon `saqarTvelos eqimis qcevis wesebiT”.
eqimTa asoicaciebs da maT mier Seqmnil sxvadasxva
struqturebs SeuZliaT ixelmZRvanelon `saqarTvelos eqimis
qcevis wesebiT” eqimis mier gaweuli samedicino momsaxurebis
xarisxis Sefasebisas, uwyveti samedicino ganaTlebis
saWiroebebis, miznebisa da amocanebis gansazRvrisas da a.S.
3.1. `saqarTvelos eqimis qcevis wesebis” aRiareba dargobrivi
asociaciebis mier
`saqarTvelos eqimis qcevis wesebs” aqvs danarTi –
`deklaracia `saqarTvelos eqimis qcevis wesebis” aRiarebis
Sesaxeb~. aRniSnul deklaraciaze xelis moweriT eqimTa
dargobrivi asociaciebi adastureben qcevis wesebis aRiarebas.
`deklaracia `saqarTvelos eqimis qcevis wesebis” aRiarebis
Sesaxeb~ inaxeba saqarTvelos eqimTa asociaciaSi.
eqimTa dargobrivi asociaciebis mier `saqarTvelos eqimis
qcevis wesebis” aRiareba Semdegnairad xdeba:
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§ `saqarTvelos eqimis qcevis wesebis” aRiarebis msurveli
eqimTa dargobrivi asociaciis xelmZRvaneli `saqarTvelos
eqimTa asociaciaSi~ waradgens Sesabamis gancxadebas,
romelsac Tan daerTveba dargobrivi asociaciis xelmZRvaneli
organos gadawyvetilebis amsaxveli dokumenti (damowmebuli
amonaweri sxdomis oqmidan, sadac miTiTebulia, rom sxdomam
miiRo gadawyvetileba, dargobrivma asociaciam aRiaros
`saqarTvelos eqimis qcevis wesebi”).
§ gancxadebis warmodgenis Semdeg dargobrivi asociaciis
xelmZRvaneli xels awers `deklaracias `saqarTvelos eqimis
qcevis wesebis” aRiarebis Sesaxeb~, riTic adasturebs
`saqarTvelos eqimis qcevis wesebis” aRiarebas. xelmowera
unda damowmdes dargobrivi asociaciis beWdiT.
§ `saqarTvelos eqimis qcevis wesebis” aRiareba SeuZlia
saqarTveloSi registrirebul nebismier eqimTa dargobriv
asociacias, nebismier dros.
§ eqimTa dargobriv asociacias, romelic miuerTda qcevis
wesebs, SeuZlia nebismier dros gaauqmos xelmowera,
risTvisac `saqarTvelos eqimTa asociaciaSi~ waradgens
Sesabamis gancxadebas.
§ `saqarTvelos eqimTa asociacia~ mudmivad aaxlebs im
dargobrivi asociaciebis nusxas, romlebmac aRiares
saqarTvelos eqimis qcevis wesebi da inaxavs dargobrivi
asociaciebis mier wardgenil gancxadebebsa da TandarTul
dokumentacias.